Business Rule Enforcement
Put even the most complex
benefit programs on autopilot
There are a lot of business rules to keep track of when it comes to employee benefits.
There are your company’s rules for who is eligible and how much to contribute to each benefit, the insurance carrier’s rules for Evidence of Insurability (EOI), premiums and coverage amounts, and IRS rules for tax-advantaged accounts like HSAs and FSAs.
With PlanSource, you can define these business rules and even automate common tasks such as canceling coverage when dependents age out or are no longer eligible.
It's Your Business. You Make the Rules.
Define coverage levels for medical, dental and vision benefits that indicate which relationships are permitted, minimum and maximum ages, and whether coverage levels and dependents must be the same across multiple benefits.
Life and Other Ancillary Benefits
Set coverage amounts for ancillary benefits as flat or salary-based mounts. You can also specify guaranteed issue and maximum amounts, rounding rules, age reduction schedules and EOI requirements.
Define eligibility and contribution rules for HSAs, FSAs and HRAs, such as employer contribution amounts, contribution maximums, e-signature requirements, and how to handle prorating and effective dates for mid-year changes.
Elements of the Automation Nation
Define your company’s employee groups where rules vary for eligibility, waiting periods, reporting, billing, cost contributions and employee communications.
Set up rules to cancel benefits automatically and according to your end-date rules when an employee loses eligibility due to a status change or when a dependent ages out.
Automate dependencies such as spouse life amounts that can only be a percentage of employee life or dependents that must match across multiple benefits.
Designate employee and employer contributions to benefit premiums by population, age, gender, coverage level and wellness questions or program participation.
Enroll employees in company-sponsored benefits automatically, and define default plans for employees that don’t enroll during new hire and open enrollment periods.
Approve or decline pending Evidence of Insurability requests from the to-do list and set them up to automatically expire after a designated period of time.