Configuring Age Parameters

To establish the age parameters in which a group benefit plan is offered, use the Age Parameters panel on the Group Benefit Plans form.

Note:  The Age Parameters panel only displays when you select an existing Benefit Plan ID which has an Insurance Class set up as Medical, Dental, Vision, Disability, or Life Insurance.

To configure the age parameters in which a plan is offered:

1. Open the Age Parameters panel.
Use this option To define this

Age Calculation (Month/Day)
• The Age Calculation Month method used to calculate employees' age for insurance premium calculations.
• The Age Calculation Day on which employees' insurance premium ages are based. The drop-down field only displays when you select a valid month (January-December).

Dependent's Age Limit

The age at which the dependent is no longer eligible for coverage. If the dependent reaches that age limit before the plan effective date, the dependent is no longer eligible for coverage. The selected value determines when the dependent age limit becomes effective:

• On Date of Birth (DOB): The dependent's age limit becomes effective on the dependent's birth date when the dependent reaches the age limit specified. For example, if the age limit specified is 25 and the dependent turns 25 on April 6, 2017, the dependent age limit becomes effective on April 6, 2017. If this date falls before the plan's effective date, the dependent is no longer eligible for coverage and cannot enroll.
• End of DOB Year: The dependent's age limit becomes effective on January 1st of the year the dependent reaches the age limit specified. For example, if the age limit specified is 25 and the dependent turns 25 on April 6, 2017, the dependent age limit becomes effective on January 1, 2017. If this date is before the plan's effective date, the dependent is longer eligible for coverage and cannot enroll.

Therefore, the dependent is longer eligible for coverage in the benefit plan even though the dependent's actual age has not yet reached the age limit specified.

• End of DOB month: The dependent's age limit becomes effective at the end of the month the dependent reaches the age limit specified. For example, if the age limit specified is 25 and the dependent turns 25 on April 6, 2017, the dependent age limit becomes effective on April 30, 2017. If this date is before the plan's effective date, the dependent is no longer eligible for coverage and cannot enroll.

If the plan effective date falls before the date the dependent's age limit becomes effective. For example, if the dependent age limit becomes effective on April 30, 2017 and the plan effective date is April 25, 2017, the dependent is still considered eligible for coverage and is able to enroll even if the dependent's actual age has reached the age limit specified.

Disabled Dependent Eligible

Whether disabled dependents who are above the age specified in the Disabled Alt Age Limit (who would otherwise be ineligible for coverage) are eligible for benefits. This field is displayed only if the Dependent's Age Limit field has a value.

Disabled Alt Age Limit

If the dependent is disabled, specify the age limit. This field is visible only if the Disabled Dependent Eligible field is checked.

Override Dependent Age Limits By State

Configure state level override(s) for Dependent Age Limits to easily manage differences in plans at the state level.

• Unchecked – (Default) The Dependent Age Limit State Overrides table remains hidden.
• Checked – The Dependent Age Limit Override table is displayed with the following column headers:
• States – Enter the state code or select from the Select States selector.
• Dep Age Limit – Provide the dependent age limit.
• Dep Age Calculation Method – Select how you want to calculate the dependent's age from the drop-down options. The available options are:
• On date of birth (DOB)
• End of DOB year
• End of DOB month
• Disabled Dep? – Specify if the dependent is disabled.
• Disabled Alt Age Limit – If the dependent is disabled, specify the age limit. This field is enabled only if you select Yes for the Disabled Dep? field.

Please note the following:

• If there are no states listed in this table, then upon saving the form an error message displays: No state listed in the dependent age limit override table.
• If you do not input any value in any of the rows in the table, then an error message displays upon saving: The [field name] for the state of [State value] is missing from the dependent age limit override table.
• The system uses the State’s Dependent Age limit and its related Calculation Method and Disabled Eligibility Limit as an override for determining when the Dependent Age Limit becomes effective. If there is no override configured for a given state in the Dependent Age Limit Override table, then the system uses the existing Dependent Age Limit (and related fields') values as default.

Use Spouse DOB for Dependent Age

Whether to use the spouse date of birth for medical, dental, and vision calculations.

Use Current Year for Age Calculation

Whether to use the current year for employee age calculations.

Base Age Calculation on Coverage Start Date

Whether to use the employee's age at the time of the coverage start date if it is greater than the age calculated by the plan based on the plan settings.

Age/Rate Date Fixed by Rate Guaranty

Whether the age and rate dates are fixed by guaranty.

When you select this field, if there are any Employee Benefit Enrollments records tied to the Benefit Plan that have a status of Active, then a message displays: There are active employees in this benefit plan. The Age/Rate Date Fixed by Rate Guaranty will not apply to employees enrolled prior to this flag being checked. The current coverage detail record for each employee will need to be saved or a new coverage detail record created in order to apply the Age/Rate Date Fixed by Rate Guaranty.

Number of Years Guaranty

The number of years guaranty for a medical, dental, or vision plan that requires age-banded billing.
2. Click Save.