Health Plans

There are three Benefit Plan types: Life Insurance, Retirement Fund, and Health Insurance.

After you have set up the Benefit Type in Type Code Maintenance, there are two steps that must be followed to set up a new plan before an employee can be enrolled:

  • The company providing the plan (life insurance carrier, health insurance carrier, or retirement plan trustee) must be set up in the Type Codes function.
  • The plan details (group number, deduction frequency, waiting period/minimum age, etc.) must be set up.

After this setup has been done, refer to the specific plan under Individuals maintenance to enroll an individual.

  1. To create a new plan, use the New button on the toolbar.
  2. Enter or select a health plan Description.
  3. If you are creating a new health plan, you can copy from an existing plan using the Copy From field drop-down list.
  4. Choose the Frequency of premium payments from the drop-down list. To add a new frequency, double-click the blue link to open the Type Codes maintenance screen.
  5. Enter the maximum age allowable for that plan in the Maximum Age Employee field.
  6. Enter the maximum dependent age allowable for that plan in the Maximum Age Dependent field.
  7. Enter the premium amount deducted from the employee's paycheck (based on frequency) in the Employee Contribution field.
  8. Enter the premium amount contributed by the employer for the frequency chosen in the Employer Contribution field.
  9. Enter the policy's Group Number.
  10. Select the company providing the plan from the Carrier Code drop-down list. To add a new carrier code, double-click the blue link to open the Type Codes maintenance screen.
  11. In the Waiting Period (days) field, enter the number of days after the employee's start date until the employee is eligible for the plan.
  12. Enter the Maximum Benefit provided.
  13. Enter the Deductible amount.
  14. Enter the Major Medical Coverage amount.
  15. Enter the maximum dollar amount the employee is responsible for in the Max Out Of Pocket field.
  16. Enter the COBRA Premium amount.

  17. Press the Add Record button () at the bottom of the screen to add data.

    • Enter the copay code Description that may represent the doctor or drug.
    • Enter the copay amount for that service in the Amount field.
  18. Click the Save button on the toolbar to save your changes.