Many of our customers have submitted questions regarding how to properly enter or modify the 2015 amounts of Medical Plan Premiums in their HRM Software when those amounts change for a new 2016 Plan Year. While some programming is being done to better assist in this area and will be available later this week, for now please review the following instructions for the scenario that best applies to you:
Scenario 1:
“During the last Plan Year we were deducting a flat premium amount, and this Plan Year the flat premium amount has changed, even though the Health Insurance Plan itself has not changed.”
For this scenario, simply go into the ACA menu, Setup, Medical Plans, and once there, select the applicable plan(s) from the drop down menu. Next click on the Costs/Deductions tab. Be sure to record and save the existing amounts shown in the Annual Plan Cost: column and Employee Share: column from the previous Plan Year. If you do not have access to documentation from your insurance company on this, you may be able to simply take a screenshot and save it for use later. In a new update coming later this week, you will be able to enter these previous plan year amounts on a separate tab page. When this has been sufficiently documented, proceed to update the amounts shown in these two columns with your new Plan Year cost and deduction amounts. When finished, click on the Update Employees Button at the bottom of the tab. This will update all employees already assigned to this plan. Click the Save button to exit.
Scenario 2:
“During the last Plan Year we were deducting an Age Rated premium amount, and this Plan Year the Age Rated amounts have changed, even though the the Health Insurance Plan itself has not changed.”
If you have been utilizing the table found in the Age Rated Costs tab in the Medical Plan Setup (just right of the Costs/Deductions tab) in the HRM Software, then the program is already set up to maintain separate rates for each Plan Year. To enter a new table, simply click on the Plan Year Ending: date box, and select a new ending date for the new Plan Year. This will create a new table for you to enter the new premium amounts, while retaining the previous table of premium amounts for use when compiling 1095-C or W-2 information for 2015.
If you have not been using the Age Rated Costs tab in the past, and manually entered the employee’s deduction amounts on the employee’s Health Benefit Record, you can either continue to manually enter the appropriate Age Rated amounts as you have been, or you can begin to utilize this automated feature now. You can begin by de-‘Active’-ating the existing record in the Health Benefits tab for each employee, and then creating a new ‘Active’ Health Benefit Record for each employee, assigning them to the same Plan, indicating coverage started the first day of the month when the new Age Rates went into effect. Then you will need to go to your Medical Plan Setup and enter the Employee Share Per:, Weeks for Deduction, Frequency:, and Payroll Deduction number(s) in the Costs/Deductions tab. You will then go to the Age Rated Costs tab, click the Age Rated check box, enter a Plan Year Ending: date, and fill in the information in the table to set your deduction amounts for this new plan. Remember to Click the Save button when finished. After all dependent information is later added to the Dependents tab in the Employee View, and after Dependent coverage has been selected on the Employee’s Health Benefits Record, the system will then use this table to calculate the premiums that need to be deducted during the applicable dates of coverage.
Scenario 3:
“During the last Plan Year we were deducting a flat premium amount, and this Plan Year the premiums are Age Rated due to a change in the Insurance Carrier, Insurance Plan, or both.”
In this scenario, entirely new plans will need to be Setup under the ACA Menu, Setup, Medical Plans. Other than deselecting the ‘Default’ check box on the old default medical plan, there is no need to further modify or delete the existing medical plans entered. Simply enter a new Plan Description and complete the rest of the plan setup (including selecting the ‘Default’ check box for the new default plan), and then click the Save button when done to save it to your list of plans in the drop-down menu. While you will still need to enter the Employee Share Per:, Weeks for Deduction, Frequency:, and Payroll Deduction number(s) in the Costs/Deductions tab, you will then go to the Age Rated Costs tab, click the Age Rated check box, enter a Plan Year Ending: date, and fill in the information in the table to set your deduction amounts for this new plan. After all dependent information is later added to the Dependents tab in the Employee View, and after Dependent coverage has been selected on the Employee’s Health Benefits Record, the system will then use this table to calculate the premiums that need to be deducted during applicable dates of coverage indicated on this Record.
Scenario 4:
“During the last Plan Year we were deducting a flat premium amount, and this Plan Year we are also deducting a flat premium amount, but the Insurance Carrier, Insurance Plan, or both have changed.” Or, conversely: “During the last Plan Year we were deducting an Age Rated premium amount, and this Plan Year we are also deducting an Age Rated premium amount, but the Insurance Carrier, Insurance Plan, or both have changed.”
In this scenario, entirely new plans will need to be Setup under the ACA Menu, Setup, Medical Plans. Other than deselecting the ‘Default’ check box on the old default medical plan, there is no need to further modify or delete the existing medical plans entered. Simply enter a new Plan Description and complete the rest of the plan setup (including selecting the ‘Default’ check box for the new default plan), and then click the Save button when done to save it to your list of plans in the drop-down menu. Be sure that existing records on the Employee’s Health Benefits tab are de-‘Active’-ated, and that new ‘Active’ Health Benefit Records are entered for each employee, assigning them to the new plan, with coverage beginning the first of the month the new plan went into effect.