SAP ABAP IMG Activity OHBEN1125 (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 OHBEN1125 Define Evidence of Insurability Conditions  
Transaction Code S_AHR_61002264   IMG-Aktivität: OHBEN1125 
Created on 19981221    
Customizing Attributes BEN_00_PA_1_2_E0202   Health plans - mandatory - non-critical - all countries but: JP,SE 
Customizing Activity BEN_00_74FR_A   View V_74FR_A 
Document
Document Class SIMG   Hypertext: Object Class - Class to which a document belongs.
Document Name OHBEN1125    

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 which plan options/dependent coverages require employees to present EOI in order to be enrolled.
  • 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 Standard Health plan requires EOI to be provided within 1 month of participation in Option II, regardless of whether it is a change in election or a new enrollment in the plan. Option II is therefore defined as an option requiring EOI.

A pending record is to be created if Option II is selected, and a grace period of 1 month from the participation start date is set.

Requirements

Standard settings

Recommendation

Activities

  1. Choose Options requiring EOI to enter the dependent coverages and plan options that require EOI.
    • If all coverages within an option require EOI, enter the option only.
    • If EOI is only required on initial enrollment, set the InitEnrol. indicator.
  2. Choose Changes requiring EOI to specify the jumps in option and/or coverage that require EOI.

    You can specify that a jump from one option to another or a change in option within a plan requires EOI.

  3. In the Action field, choose the appropriate procedure for creating infotype records in cases where EOI is required but not yet provided.
  4. 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

If you enter an option as requiring EOI, you do not need to enter all jumps to this option as changes requiring EOI. The fact that the option is defined as requiring proof is sufficient to ensure that any employee changing to this option is required to provide EOI.

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

1 - Create an active record for the chosen option

2 - Create a pending record for the chosen option

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

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.

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 OHBEN1125 0 HLA0100328 Health Plan 
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_A V - View HRBEN0041  
History
Last changed by/on SAP  20000117 
SAP Release Created in