Benefits

The Benefits screen allows users to create Plans, Rates, track Missing Payments, FRS Deposits, and more.

The following tabs must be completed before employees/users can apply for Benefits during the open enrollment period specified via Setup > Settings > ESS: Plans, Rates, and Open Enrollment.

Plans

1. From the Human Resources menu, click Benefits.

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2. Click the Plans tab.

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The Plans tab displays existing plans and the Type of plan, type of Coverage, Liability Account, Provider, Option, Medicare Eligible Plan indicator, Active plan indicator, Months in Advance effective, Deduction, Contribution, and Description.

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3. To add a new plan, enter data in the top row starting with the Type of plan.

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4. Select the Type of plan from the pull-down, such as Medical, Dental. Vision, Core Life, or Supplemental Life.

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5. Select the Coverage type, such as Employee Only, Employee + Spouse, etc.

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6. Select the Liability Account from the pull-down.

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7. Enter the Provider of the plan, such as FL Blue for a medical plan or Lincoln Financial for life insurance.

8. Enter the Option in the provided text box.

9. Select the Medicare Eligible Plan check box to indicate that the plan is elegible for medicare.

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10. Select the Active check box if the plan is available for use. Leave the check box cleared to flag the plan as inactive.

11. Enter the number of Months in Advance benefits should be paid from the payroll run via Payroll > Run Payroll > Runs tab; for example, if your district pays teachers 3 checks in one for the summer, 3 months of benefits would be paid in the same run.

12. Select the Deduction from the pull-down.

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The information selected from the Deduction and Contribution pull-down will populate on the employee’s Deduction tab if that plan is selected and Recalculate Benefit Deductions is clicked.

13. Select the Contribution from the pull-down.

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14. Press the Enter key to save the plan.

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Once saved, the line turns blue and the delete button (red minus sign) displays.

15. Once saved, the View button displays. Click the View button to add a plan description.

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a. Enter the plan description in the provided text box and click Save. Click the white X to close the pop-up window without saving the description.

16. Select the Auto recalc month/year check box to automatically recalculate benefit deductions as opposed to making manual recalculations based on the month and year selected.

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a. Select the applicable Employee from the corresponding pull-down for which recalculation is to be completed. The pull-down defaults to All Staff.

b. Click Recalculate Benefit Deductions to update benefit deductions for employees.

17. Select the Recalc month from the pull-down for which recalculation is to be completed to apply a manual recalculation.

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This selection ensures that if a benefit is not valid for a particular month, the benefit will not pull into the run via Payroll > Run Payroll. For example, an employee is not eligible for health insurance until October and is not prepaid; therefore, that deduction would not come out of the employee’s paycheck if the employee is working and being paid in September.

18. Select the Calendar year from the pull-down for which recalculation is to be completed.

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19. Select the applicable Employee from the corresponding pull-down for which recalculation is to be completed. The pull-down defaults to All Staff.

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20. Click the Recalculate Benefit Deductions button to update benefit deductions for employees.

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A Successfully recalculated benefit deductions report displays a detailed report that documents changes made when Recalculate Benefit Deductions is clicked.

Once the recalculation is complete, the month selected displays via Human Resources > Employee > Benefits tab in the Benefit recalc month field.

21. To edit existing plans, click the pull-down and change the selection, as needed. You can also click any text fields to change data entered here. Check boxes can be selected or cleared of selection.

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22. Click the delete button (red minus sign) to delete the plan.

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Rates

1. From the Human Resources menu, click Benefits.

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2. Click the Rates tab.

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3. Select the applicable calendar year from the pull-down.

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The Rates tab displays rates assigned to Plans, including the Plans, Title, Years Employed (Min - Max), Employee Age (Min - Max), State, Zip Codes (Start - End), Rate, Employer Subsidy Amount, and Flexible spending: Min - Max.

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4. To add a new rate, begin entering data in the top row.

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5. Select the plan from the Plans pull-down for which you are adding a rate.

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6. Enter the Title of the rate.

7. Enter the Min and Max for Years Employed if this is applicable to the rate of the plan. For example, to qualify for specific kinds of insurance, you must be employed for at least 2 years.

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8. Enter the Min and Max for Employee Age if this is applicable to the rate of the plan. For example, to qualify for Medicare/Medicaid insurance, you must be a specific age.

9. Select the qualifying State from the pull-down.

10. Enter the Start and End for Zip Codes if this is applicable to the rate of the plan.

11. Enter the Rate in the provided text box.

12. Enter the Employer Subsidy Amount to indicate the amount the employer is responsible to pay for the plan.

13. Enter the Employer Subsidy Percentage to indicate the percentage the employer is responsible to pay for the plan; for example, most employer's contribute 50% of employees' health insurance.

14. Enter the Flexible spending: Min - Max amounts in the provided text boxes, if applicable.

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15. Press the Enter key to save the rate.

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Once saved, the line turns blue and the delete button (red minus sign) displays.

16. You can edit existing rates by clicking the text fields and changing the information or by clicking the pull-downs and changing the selections.

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17. To delete a plan's rate, click the delete button (red minus sign).

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Open Enrollment

1. From the Human Resources menu, click Benefits.

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2. Click the Open Enrollment tab.

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Coverage Disable

The Coverage Disable tab allows  you to disable specific coverage for employees, such as Employee + Spouse.

1. The Open Enrollment tab defaults to the Coverage Disable tab.

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2. Select the type of Coverage that should be disabled from the pull-down.

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3. Press the Enter key to save the selection.

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4. To edit a selection, click the pull-down and change the selection. Changes save automatically.

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5. To delete a selection, click the delete button (red minus sign).

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Introductions

The Introductions tab allows users to set up introductions and announcements that display via Employee Self Service > Benefits.

1. From the Open Enrollment tab, click the Introductions tab.

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2. Enter the Title of the introduction. The title entered here displays on Employee Self Service. You can leave the Title field blank if you don't want a title to display.

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3. Select the where the introduction should display from the Target pull-down, such as Personal Info tab.

4. Press the Enter key to save the title and target in order to add an introduction.

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5. Click View Introduction to add an introduction.

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a. Enter the introduction or any district announcements and click Save.

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6. Click the Title field to make an edit or click the Target pull-down to change the selection. Click View Introduction to edit the introductory text.

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7. Click the delete button (red minus sign) to delete an introduction.

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IRS Relationship Disable

The IRS Relationship Disable tab allows users to determine which relationships should be disabled.

1. From the Open Enrollment tab, click the IRS Relationship Disable tab.

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2. Select the Type from the pull-down, such as Beneficiaries.

3. Select the Relationship from the pull-down.

4. Press the Enter key to save the disabled relationship.

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Custom Relationships

The Custom Relationships tab allows users to set up relationships as beneficiaries and dependents as well as the applicable coverage.

1. From the Open Enrollment tab, click the Custom Relationships tab.

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2. Select the Type from the pull-down, such as Dependents.

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3. Enter the Relationship in the provided text box.

4. Select the type of Coverage that can be applied.

5. Press the Enter key to save the custom relationship.

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6. Click the Type or Coverage pull-down to change the selection or click the Relationship field to edit the text. Changes save automatically.

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7. Click the delete button (red minus sign) to remove a custom relationship.

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Files

The Files tab allows users to upload files that need to be reviewed and/or completed by employees upon applying for benefits. The files uploaded here display via Employee Self Service > Benefits > Review tab > Files section.

1. From the Open Enrollment tab, click the Files tab.

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2. Select the Plan type from the pull-down.

3. Enter the File Name, such as Spousal Affidavit, in the provided text box.

4. Select the Required check box to ensure employees complete the required file before submitting benefits request.

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5. Press the Enter key to save the file information.

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6. Click the Description button to add file information including any files or links that should be included.

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a. Enter the file description and click Save.

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7. Click the Plan type pull-down to change the selection or click the File Name to edit the text. Select or clear the selected Required check box or click Description to edit the file description, as needed. Changes save automatically.

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8. Click the delete button (red minus sign) to delete the file information.

Multiple Plan Types

The Multiple Plan Types tab allows users to determine when employees are allowed to be enrolled in multiple plans of the same benefit type.

1. From the Open Enrollment tab, click the Multiple Plan Types tab.

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2. Select the Plan Type from the pull-down.

3. Press the Enter key to save the plan.

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4. To edit the plan type, click the Plan Type pull-down and change your selection. Changes save automatically.

5. To delete an entry, click the delete button (red minus sign).

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Declined Plans

The Declined Plans tab allows users to determine the type of plans that are declined.

1. From the Open Enrollment tab, click the Declined plans tab.

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2. Select the Plan from the pull-down.

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3. Press the Enter key to save the entry.

4. Click the Plan pull-down to change the selection. Changes save automatically.

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5. Click the delete button (red minus sign) to remove the entry.

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File Download

The File Download tab allows users to download specific benefit files, such as FRS or ACH files.

1. From the Human Resources menu, click Benefits.

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2. Click the File Download tab.

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3. Select the File from the pull-down.

4. Enter the Effective Date.

5. Click Download.

6. Click the file in the Downloads section.

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Once dowloaded to your computer, you can view the document in the applicable format, such as CSV or TXT.

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FRS Contribution

The FRS Contribution tab allows users to upload a TXT file in order to import FRS payments to Focus.

1. From the Human Resources menu, click Benefits.

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2. Click the FRS Contribution tab.

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3. Click Browse... to upload a TXT file from your computer.

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4. Once the file is attached, click Import.

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5. Click Revert to view Import History.

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From the Import History pop-up window, review the information, such as Imported at date and time, the Import count, Import code, and Plans included. Click Revert for the correct import record to remove the information previously imported.

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FRS Changes

The FRS Changes tab allows users to generate a report based on a select month to review life insurance rate changes and employees turning 65 years old.

1. From the Human Resources menu, click Benefits.

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2. Click the FRS Changes tab.

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3. Enter the applicable month in the Changes the month after text box. Clicking the text box opens the month and year pull-downs for selection. Then, click Done. You can also click Today to select the current date so changes aren't applied until the following month.

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The Life Insurance Rate Changes section displays the Staff ID, Last Name, First Name, Plan, Old Rate, and New Rate.

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The Employees Turning 65 section displays all employees turning 65 including the Staff ID, Last Name, and First Name.

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Missing Payments

The Missing Payments tab allows users to review employees that have missed benefit payments as well as payment that do not equal benefit premium amount. The report displays employees that have overpaid or underpaid or have been overpaid or underpaid by the district.

1. From the Human Resources menu, click Benefits.

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2. Click the Missing Payments tab.

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3. Enter the applicable month in the Missing payments for text box to pull missing payment information for the corresponding month. Clicking the text box opens the month and year pull-downs for selection. Then, click Done. You can also click Today to select the current date.

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The Benefits with Missing Payments section displays the Staff ID, employee's Full Name, Benefit Title, and FRS Eligible.

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FRS Deposits

The FRS Deposits tab allows users to view the deposits made broken down by insurance type and accounts.

1. From the Human Resources menu, click Benefits.

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2. Click the FRS Deposits tab.

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3. Enter the applicable month in the FRS deposits on text box to pull deposits made for FRS for the corresponding month. Clicking the text box opens the month and year pull-downs for selection. Then, click Done. You can also click Today to select the current date.

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View FRS deposit Total by Insurance Type, which displays the total deposit made per insurance type, such as dental, vision, etc.

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View the FRS deposited Amount by Account, which displays the Account ID, Account Title, and Amount.

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Insurance Deposit

The Insurance Deposit tab allows users to generate an insurance deposit summary by employee and account based on an effective date.

1. From the Human Resources menu, click Benefits.

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2. Click the Insurance Deposit tab.

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3. Enter the Effective Date in the text box.

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4. Click Download.

The Deposit Summary by Employee section displays the employee's Full Name, Dental deposit amount, Vision deposit amount, Supplemental deposit, Medical deposit, Core deposit, Total, and the Cov. Month.

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The Deposit Summary by Account section displays the Account Title, the Total deposited, and the Cov. Month.

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Detailed Coverage Invoice

The Detailed Coverage Invoice tab allows users to generate a report of medical coverage invoices by a select invoice month.

1. From the Human Resources menu, click Benefits.

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2. Click the Detailed Coverage Invoice tab.

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3. Enter the invoice month in the Select date for invoice text box. Clicking the text box opens the month and year pull-downs for selection. Then, click Done. You can also click Today to select the current date.

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The Detailed Medical Coverage Invoice report displays the Employee, SSN, Gender, Age, Retirement Date, Years of Experience, Cov. Month, Item Description, Item Price, and District Cost.

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Enrollment Summary Sheet

The Enrollment Summary Sheet tab allows users to generate a PDF print preview of employee benefits.

1. From the Human Resources menu, click Benefits.

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2. Click the Enrollment Summary Sheet tab.

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3. Enter the Effective Date in the provided text box.

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4. Click Print.

5. From the Enrollment Summary Preview screen, click the Printer icon to print or click the Download icon to download the file to your computer.

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Claim Reconciliation

The Claim Reconciliation tab allows users to compare the coverage file with the claim file. The tab contains the Invalid Claims tab and the Valid Claims tab.

1. From the Human Resources menu, click Benefits.

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2. Click the Claim Reconciliation tab.

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3. Click Choose File to upload a Service File and a Coverage File to compare to two against one another.

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4. Once the file is selected from your computer, click Submit.

[FOCUS-23263] Creating Claim Reconciliation tab in benefit screen - JIRA

5. Click the Invalid Claims tab to view claim files that do not compare with the employee's coverage file.

The Invalid Claims tab displays the employee's SSN, the Member name, the Employee Name, Relationship, Medical Enrollment Date, Medical Term Date, Service Date, and the Claim Number.

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6. Click the Valid Claims tab to view claim files that accurately compare with the employee's coverage file.

The Valid Claims tab displays the employee's SSN, the Member name, the Employee Name, Relationship, Medical Enrollment Date, Medical Term Date, Service Date, and the Claim Number.

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