FAQ for Benefit Management: Eligibility Rules: Elected Benefit vs Current Benefit

When creating an Eligibility Rule based on benefits, it is best to use one of the "Elected" fields.

  • Elected Benefit Coverage Name
  • Elected Benefit Name
  • Elected Benefit Plan Name
  • Elected Non-Waive Benefit Names

When going through an Event, any election an employee makes are placed in a Temp Table. The "Elected Benefit" fields looks at the benefits that are in the Temp Table and then verifies if the Employee is eligible or not. If the employee does not have an active event, then the eligibility rule will look at the employee's active elections. Please note that the Eligibility Rule will always evaluate the latest elections by Effective Date.

"Current Benefit" fields do not look at the Temp Table. Instead, they look at what an employee is currently enrolled in; it does not look at what they are electing to enroll in.

Troubleshooting Elected Eligibility Rules

  • Extend the End Dates of the Employee > Benefits > Benefits screen to see if any future dated benefits exist. Determine if the employee is eligible for this election as of that last Effective Date.
  • If you don't see any future dated benefits via the Benefits screen, navigate to Data > Exports > Manage > Quick Excel Exports and click Export Employee Benefits. Put a filter on the Effective Date column and verify if there are any future dated benefits.
  • Check the Employee Homepage to see if the employee has an open event. You should be able to determine if the employee is currently selecting a coverage level that disqualifies them from eligibility.

Example - Elected Benefit: An employee is going through an Open Enrollment Event where there is a Medical Benefit and an HSA Benefit. The eligibility rule for the HSA Benefit says: if the Elected Benefit Plan Name is equal to Choice Plus HSA Plan, then the employee is eligible for the HSA benefit.

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- If the Employee decides to waive the Medical coverage, then when they get to the HSA benefit they are not eligible. That is because the Temp Table says they are electing to Waive Medical.

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- If the Employee decides to enroll in the Medical HSA coverage, then when they get to the HSA benefit the are eligible to enroll. That is because the Temp Table says they are electing the Medical HSA coverage.

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Example - Current Benefit: An employee is going through an Open Enrollment Event where there is a Medical Benefit and an HSA Benefit. The eligibility rule for the HSA Benefit says: if the Current Benefit Plan Name is equal to Choice Plus HSA Plan, then the employee is eligible for the HSA benefit.

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Since the Eligibility Rule above uses the field Current Benefit Plan Name, then the Employee would only be eligible if they were currently enrolled in the Medical HSA plan. Currently, the employee is enrolled in Waive but they want to enroll in the Medical HSA plan during Open Enrollment. Since they are currently enrolled in Waive, they are unable to enroll in the HSA Benefit. That is because the "Current Benefit" field is NOT looking at the Temp Table and does not recognize that the employee is trying to elect HSA coverage.

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