Insurance And Benefits > Process > Enter/Edit Insurance and Benefits Master

Most Recent Update: 
6.143 - Removed the filter on tax year which was previously only showing last 5 years.
6.98 - Allow benefits to be deleted if they have no assigned dependents.
6.16
Added "Year" drop-down box so users can now specify which tax year the list of benefits apply to.

Introduction

Benefits can be added or edited on an employee by choosing the Process menu option and then selecting “Enter/Edit Insurance & Benefits Master”.

Prerequisites

  • New employees must be first entered in Payroll or Personnel before benefits can be added in the IB module.
  • Before a benefit code can be assigned to an employee, the benefit must be added and defined in the Benefits Parameter menu. Also the Create Benefits from Payroll menu can help add benefits in bulk using payroll deductions.

Explanation

The following employee information is available for user reference but cannot be edited. Adjustments to these values is keyed into the Personnel or Payroll modules.

  • Employee ID
  • SSN
  • Last/First/MI
  • Pay Group
  • Location
  • Salary Class
  • Category
  • Class
  • Department
  • Address 1
  • Address 2
  • City/State/Zip
  • Phone
  • Alternate Phone
  • Race
  • Sex
  • Date of Birth
  • Date Employed
  • Date inactive

Benefits are entered in the lower half of the data entry screen. The Year drop down box will filter the list of benefits based on the Tax Year. The data entry line, designated by the '+' button, is where each benefit is entered/edited. As each benefit record is saved, it appears in the grid.

Adding a Benefit

Select a Tax Year for the benefit code you will be adding by clicking on the Year "down arrow". If the desired year does not exist, click on the green plus button next to the year field to add a new year.

Select a Benefit Code from the list that is displayed when you click the “down arrow” beside the benefit code field. The year is required so this field will be disabled if no year exists.

The Abbreviation set in the Benefits Parameter will automatically be displayed. A % symbol will display next to the description of benefits that are set up as a percent in the Benefits parameter settings.

Enter the following fields as appropriate

  • Premium
  • Number of Checks
  • Effective Date
  • Standard Amount
  • Current Amount
  • Employer Cost
  • Ceiling AMount
  • Employer Subsidy
  • PR Change Date

Save the Benefit

Benefit Details

To see the detailed information about a benefit displayed in the list, click on the magnify icon beside the benefit code.

All Benefits have the following details available:

Premium - is the monthly premium cost to the employee.
#of checks- is the number of checks that the annual cost of the benefit should be allocated to.

For example, if the employee will receive 26 checks in the year and the insurance premium will be deducted from each check, enter 26 as the number of checks. If you are using the Payroll module, the number of checks for IB can be set in that module’s “Pay Group” parameter file. The default premium from the Benefits parameter settings will be displayed.

Effective date - this is the date that the benefit goes into effect for the employee.

Note: This is a very importan setting for accurate IRS Forms 1094-B, 1095-B, 1094-C and 1095-C.

Std. Amt (Standard Amount) - is calcuated by annualizing the monthly premium and then dividing the annual premium by the number of checks
Curr Amt (Current Amount) - overridides the standard amount if necessary.

Employer Cost is the cost to the employer. This should default from the Benefits Parameter

Employer subsidy is used in conjunction with clients who use the Export MPPI File. The employer subsidy is the portion of the employee cost that is paid by the employer. Clients that pay a subsidy must enter the employer subsidy amount for each employee before submitting their next MPPI file.

PR Change Date is the date that the benefit change is to become effective in the Payroll module. The Insurance & Benefits changes will not automatically update to the Payroll module on the effective date. The window “Update Benefits to Payroll” uses this date to select the changes that you choose to update to the payroll system. When you run the update option, all benefit changes with a PR Change Date within your selected date range will be updated.

Notes - An unlimited amount of text can be typed in the Benefit note field. Click the button to see the full note.

Example: You are in the month of November and have made some benefit changes you wish to go into effect in November and some on December 15th. When you upload your changes to Payroll to activate the November changes, you would select a date range that would include your November dates. (Ex: 11/01/2002 to 11/30/2002.) This would upload all November changes and put them in effect for the next payroll run. The changes you wanted to take place in December would be unaffected at this point.

To activate the December changes, you would wait until the "change date" and then upload those changes to Payroll by selecting a date range that would include your changes (e.g., 12/01/2002 to 12/15/2002). Once that is done, those benefits would then be active for the next payroll run.

Heath Benefits have a few additional details:

IRS benefit offer code - This indicates which Code Series 1 value to use for this benefit when reporting this benefit in box 14 of the IRS Form 1095-C

Code Series 1 Options

1A. Qualifying Offer: Minimum essential coverage providing minimum value offered to full-time employee with employee contribution for self-only coverage equal to or less than 9.5% mainland single federal poverty line and at least minimum essential coverage offered to spouse and dependent(s).
1B. Minimum essential coverage providing minimum value offered to employee only.
1C. Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to dependent(s) (not spouse).
1D. Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to spouse (not dependent(s)).
1E. Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to dependent(s) and spouse.
1F. Minimum essential coverage NOT providing minimum value offered to employee, or employee and spouse or dependent(s), or employee, spouse and dependents.
1G. Offer of coverage to employee who was not a full-time employee for any month of the calendar year and who enrolled in self-insured coverage for one or more months of the calendar year.
1H. No offer of coverage (employee not offered any health coverage or employee offered coverage that is not minimum essential coverage).
1L. Qualifying Offer Transition Relief 2015: Employee (and spouse or dependents) received no offer of coverage, received an offer that is not a qualifying offer, or received a qualifying offer for less than 12 months.

Decline offer of coverage - use this checkbox to indicate the employee has declined the benefit. This effects how Codes Series 2 is applied on box 16 of the IRS Form 1095-C.

The Decline offer of coverage and Minimum employee only contribution amount are both option and will only be editable if an IRS benefit offer code is selected.

Minimum employee only contribution amount - this is value used in box 15 of the IRS Form 1095-C.
Plan Code - Coverage Code
Dependents Tab - this is where spouses and dependents can be be specified for IRS Forms 1094-B and 1095-B and IRS Forms 1094-C and 1095-C.

Dependant information may be duplicated from another benefit by pressing the Dup button. Dependent Information can be imported in bulk from Import Dependents in the Maintenance Menu.

Troubleshooting

  • The benefit must be saved on the first page before accessing the detailed information.
  • Changes made to the detail page immediately show up on the summary page.
  • If the benefit is coded with a W (workers comp) or E (employer cost only) in the Deduction Parameter file in Payroll, the Annual Premium, Standard Amount and Current Amount fields will be disabled.
  • The user’s initials will also be tracked on all changes that are made to the employee’s benefit. This is displayed next to the PR Change Date field.

Reference

Insurance And Benefits
Benefits Parameter