Coverage code and Coverage group code in PeopleSoft Benefits

Coverage code and Coverage group code in PeopleSoft Benefits

Coverage code

coverage code that defines who can be covered by a benefit, use the Health Coverage Codes (COVERAGE_CODES) component.

You define and manage coverage codes for your benefit programs using the Coverage Code table. You will attach these coverage codes to your benefit plan options on the Benefit Program table.

PeopleSoft Manage Base Benefits delivers nine basic coverage codes for which you define a minimum and maximum allowable for each eligible covered person type. These delivered coverage codes are described in this table:

You should create a new Coverage Code or modify your existing Coverage codes as appropriate to include the Covered Person type of Adult Child.

COBRA Coverage Set

A 2-character code that is used to group coverage codes together for COBRA eligibility purposes. When an individual experiences a COBRA event, the system must adjust the range of coverage codes available to each qualified beneficiary. By restricting itself to a specific set of coverage codes, COBRA processing can more accurately determine which benefit options to present to a participant who is eligible for COBRA coverage. If COBRA coverage sets are not established, then COBRA processing may encounter multiple equivalent coverage codes, and eligibility determination may fail.

Understanding Coverage Group Codes

Life insurance and accidental death and dismemberment (AD/D) plans use coverage group codes to establish the maximum lifetime coverage allowed.

For example, if you define a coverage group code with a 500,000 USD maximum, then enter that coverage group code for a supplemental life plan and a group life plan, and associate both benefit plans with a benefit program. If you were to enroll an employee in both of those plans, the system would ensure that the employee's total coverage by both plans does not exceed 500,000 USD.

If the total coverage for a participant exceeds the coverage maximum, the system reduces the total coverage to meet the coverage maximum. When the system processes the deduction, it accumulates the coverage amounts and begins reducing coverage when the coverage group maximum is reached. The system processes plans in order of deduction priority, and if more than one plan has the same priority, it processes in increasing plan type order.

In this case ABC is the new coverage code with coverage Maximum of 10000000USD.Enter the maximum total life and AD/D coverage.

This amount applies to all the life and AD/D benefit plans that you associate with the coverage group code and that you associate with one benefit program. You connect a life or AD/D plan with a coverage group code using the Life and AD/D Plan table.

PeopleSoft Base Benefit vs Benefit Administration

Base Benefit

·         Base Benefits is where you store the Core Tables and Employee Benefit 

Records

·         Base Benefits will allow you to store benefit plans, create benefit programs to group the plans and the employee elections by plan. You can set up the plan rates here as well as coverage codes. Base Benefits works well if you are handling benefit enrollments manually or if you use an outside TPA for your enrollment and just want to store the employee elections in the system. If you set up the rates with the plans it does work with PeopleSoft Payroll in calculating the deduction amounts per pay. 

·         Base Benefits automatically passes deduction information to PS Payroll and 

the maintenance of employee enrollments is manual while BenAdmin determines 

Benefit Program and Benefit Plan eligibility based on the rules that are 

setup and it ensures data integrity. Employee Self-Service Enrollment is 

also available when using BenAdmin. It is integrated with COBRA processing 

as well as Benefits Billing. 

Benefit Administration

·         Benefits Administration uses what you set up in base benefits, but also creates events which can be triggered to allow employees to enroll or change their elections (think new hire, annual enrollment, family status events, etc.). It also allows you to create eligibility rules to determine what plans employees are eligible to enroll in. You cannot use Ben Admin if you do not have base benefits set up or it won't have any plans and programs to tie to events. When events are finalized in Ben Admin, it will load the benefit elections into the base benefits table. See how it all relates? If you handle benefits enrollments in house, Ben Admin might be the way to go for you as it will also allow you to use self-service for the employees to make their elections. 

·         BenAdmin automates the administration of Benefits using 

Eligibility Rules and Event Rules.

·         Once BenAdmin events are finalized, it writes the employee elections to 

Base Benefits.

An error has occurred that has stopped this transaction from continuing:PeopleSoft Error

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1.  This message appears due to 0 rows in PS_INSTALLATION Table

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Solution:Correct the code and check the page again

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