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OHFBN1187 - Define Coverage Rules

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In this step, you define the actual coverages for a plan.

You need to define coverage for each possible combination of employee grouping in the criteria you have attributed to each variant. If you have not specified any criteria in a variant, you assign one rule only.

Coverage can be defined as a flat amount or as a factor of salary.

The Standard Life insurance plan has the coverage variants 40KK and 70KK. Two coverage rules are set up as follows:

Plan	Cov. variant	Coverage amount
Standard Life	40KK	$40,000
Standard Life	70KK	$70,000

70KK

The Extra Life insurance plan has the coverage variant BASC. Two coverage rules for BASC are set up as follows:

Plan	Cov.variant	Salary grp	Maximum coverage
Extra	BASC	$0-$20,000	$70,000
Life	BASC	$20,001+	$90,000

$20,001+

1. Determine the different coverages that apply to different groups of employees in your organization.
2. Select the plan and coverage variant for which you want to define coverage rules, as prompted.
3. Choose New entries.
4. Enter the combination of employee groupings for which you want to define coverage rules.

To help you, the system will only allow you to enter those employee groupings that you defined as relevant in the coverage variant.

1. Enter the validity dates for the rule.
2. Enter the coverage as either a flat amount or as a factor of salary.

If coverage is dependent on salary, the benefit salary is used as the basis.

1. If required, enter a rounding rule and divisor to determine how coverage is to be rounded.
2. Specify the minimum and/or maximum coverage, if required.
3. Save your entries.
4. Choose Back and repeat steps 2 to 9 for each coverage rule, for each variant in each plan.

$20,001+




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