SAP ABAP IMG Activity OHBEN069 (Define Evidence of Insurability Conditions)
Hierarchy
☛ SAP_HRRXX (Software Component) Sub component SAP_HRRXX of SAP_HR
   ⤷ PA-BN (Application Component) Benefits
     ⤷ PBEC (Package) Benefits - Customizing
IMG Activity
ID OHBEN069 Define Evidence of Insurability Conditions  
Transaction Code S_AHR_61002404   IMG-Aktivität: OHBEN069 
Created on 19981221    
Customizing Attributes BEN_00_PB_1_2_E0103   Insurance plans - mandatory - non-critical - all countries but JP 
Customizing Activity BEN_00_74FR_B   View V_74FR_B 
Document
Document Class SIMG   Hypertext: Object Class - Class to which a document belongs.
Document Name OHBEN069    

For certain levels of coverage, employees may be required to provide evidence of their insurability. In this step, you define evidence of insurability (EOI) requirements in accordance with the policies of the plans that you offer.

You can perform the following activities in this step:

  • Specify the plan coverage amounts above which the employees must present EOI in order to be enrolled and in the situations in which EOI is required for these amounts.
  • Define the changes in election that require EOI.
  • Determine the action the system should take if EOI is not provided at the time of enrollment.
  • Specify grace periods within which the employee must provide EOI.

Example

The Extra Life insurance plan allows coverage multiples of $10,000 up to a maximum of $250,000. EOI is required in the following situations:

  • On initial enrollment, for all coverages
  • On any increase in coverage of $50,000 or more
  • For coverages of more than $200,000

The maximum coverages allowed without provision of EOI are as follows:

Initial enrollment    $0.01

Change in coverage    $49,999.99

Enrollment any time    $200,000

A pending record is to be created in cases where EOI is required but not provided, and a grace period of 10 months from the enrollment date is set.

Requirements

Standard settings

Recommendation

If EOI is required for a new enrollment, regardless of coverage, enter $0.01 as the coverage above which EOI is required on initial enrollment. If you do not make an entry the system assumes that no EOI is required for new enrollments.

Activities

  1. Enter the maximum coverages without provision of EOI.

    You can enter coverage thresholds either as flat amounts or multiples of the employee's benefit salary or both. If you enter both, the coverage threshold is the sum of these two values.

  2. If required, enter a rule and divisor to determine how coverage is to be rounded.
  3. If you want the benefit salary on which coverage is based to be calculated on a day other than the calculation base date, enter a cutoff day.
  4. In the Action field, choose the appropriate procedure for creating infotype records in cases where EOI is required but not yet provided.

    For more information on the possible system actions, see the further notes below.

  5. If required, enter the grace period, within which employees must provide EOI, and specify whether the grace period starts on with enrollment participation.

Further notes

In the event of EOI not being provided at enrollment, the system can create infotype records in any one of the following ways:

1 - Create an active record for the chosen option

2 - Create a pending record for the chosen option

3 - Create an active record for maximum possible coverage/jump in coverage

4 - Create a pending record for the chosen option (a) and create an active record for the maximum possible coverage/jump in coverage (b).

The action that you choose determines how the infotype records created during enrollment are attributed.

    Action    Locked    EOI reqd    EOI provided

EOI provided    n/a        x    x

EOI not provided    1        x

    2    x    x

    3

    4(a)    x    x

    4(b)

These attributes are read by the EOI Monitor, which displays the status of EOI provision and indicates whether enrollments are pending or active. Pending enrollments are those for which the infotype record is locked.

If you select either action 3 or 4, the maximum possible coverage/jump in coverage that is permitted by the plan without provision of EOI is automatically determined during enrollment and entered as the alternative coverage on the active infotype record. Note that if you select action 3, employees do not have the opportunity to subsequently provide EOI in order to be given a higher coverage, the alternative coverage is fixed until a new enrollment or changes to enrollment are possible.

Business Attributes
ASAP Roadmap ID 203   Establish Master Data 
Mandatory / Optional 1   Mandatory activity 
Critical / Non-Critical 2   Non-critical 
Country-Dependency I   Valid for countries specified 
Assigned Application Components
Documentation Object Class Documentation Object Name Current line number Application Component Application Component Name
SIMG OHBEN069 0 HLA0100329 Insurance 
Maintenance Objects
Maintenance object type C   Customizing Object 
Assigned objects
Customizing Object Object Type Transaction Code Sub-object Do not Summarize Skip Subset Dialog Box Description for multiple selections
V_74FR_B V - View HRBEN0041  
History
Last changed by/on SAP  20000117 
SAP Release Created in