Rolling Health Care Plans (Benefit Plans that Run on Different Rate Years)

Modified on Mon, Sep 23 at 1:09 PM

View the recording of the Webinar from April 17, 2024

For example – a district’s health plans run on a fiscal year basis (July 1st through June 30th).  Their dental plans run on a calendar year basis (January 1st through December 21st)). 

Our recommendation, to ensure payroll deductions and reporting are complete and accurate, for every plan is to set your health plan year and your employee’s health tracking records to 6 month intervals.  You will then process a rollover for ALL plans every 6 months.   

During the rollover, you will only update the rates for those plans whose premiums (rate year) change at that time.  For example, you are rolling over for July 1st.  Your health and prescription plan rate change at this time, but your dental plan rates do not change until January 1st. 

In this example, we are rolling over plans for July 1, 2024 (Old Plan year was 1/1/2024-6/30/2024).  The New plan year will be 7/1/2024-12/31/2024 for ALL PLANS.

Step 1 – Copy Health Plans to next period

Go to the Personnel > Setup > Health Plans > List of Plans screen:

In the first column, check the boxes for plans you wish to roll over, and click the “Rollover Checked Plans” button.  We recommend the District leave the increase at “0” and click the “Rollover” button.

Step 2 - Setting the Plan Year (Must be done for ALL PLANS):

Navigate to the Personnel >>> Setup >>> Health Plans >>> List of Health plans. You will set the Plans Active on to the first day of the new Plan Year and click on the Search button.

The system automatically creates the next plan year with 12 months. This MUST BE ADJUSTED to the proper period. In this example, the rates change every 6 months, so, the plan year MUST be 6 months and the Health Tracking Thru date would be December 31, 2024.

You will need to go into each plan and manually change the end date to the LAST DAY of the Plan Year. FOR THIS EXAMPLE, THE PLAN THRU DATE MUST BE SET TO 12/31/2024.

After all of the Plan dates are updated to the proper dates for this example:

Step 3 – Setting the Rate Year and enter the new rates for the new Rate Year

Be sure you are in the next period by changing the Plans Active On date field to the start date of the next period (which is 7/1/24 for this example). The Plan Year should be same for ALL PLANS. Then, review the Rate Year for all plans.

If the Rate Year End date is before the Plan Year Start date, then the Rate Year and the Rates MUST be updated. In the sample below the health and prescriptions plans, highlighted in red, has a Rate Year End date before the Plan Year Start Date and as such, the Rate Year and the Plan Rates MUST be changed.

To update the Rate Year and the Rates, click on the Edit button for the plan and update the field highlighted in red below:

Step 4 – Setting the Associated Plans for all Health Plans

For each rolled over HEALTH (MEDICAL) PLAN, you MUST review the Associated Plans and ENSURE the Associated Plans are updated to the respective rolled over plans.

Step 5 - Reviewing / Updating the Chapter 78 Contribution Chart

On the Member Contributions tab, enter the first date of the new year / period and click on the Search button. If no records are returned, click on the Create Chapter 78 Records button.

Enter the dates and click on the Create button:

Step 6 - Reviewing / Updating the Custom Contribution Groups

On the Member Contributions tab, click the Search button to view the Contribution Groups currently available:

Change the As of Date to the END of the new health plan period / year and click on the Search button (the background should turn to green). Review and identify any custom contribution groups that are currently available and WILL NOT be available at the end of the new health plan period / year. In this example, the "Garden State (buy Up Medical)" plan is currently available bot NOT available in the future. This plan will need to be updated / modified.

To modify a plan, change the As of Date back to today and click search. Locate the plan that is NOT available in the the new health plan period / year and click on the Edit button.

If any of the percentages, flat amounts or Salary Caps change in the new health plan period / year Mark the row by checking the box on the left hand side and click on the Copy Checked button.

Enter the From Date and the Thru Date for the new health plan period / year and set the sequence number for the first new record. We recommend you select a sequence number higher than the last current sequence number. Then click on the Copy button.

Then the District can update the percentages / flat monthly amounts / salary caps for the newly created records (in the new health plan period / year

Step 7 – Rolling staff into the new Plan Year (NOT utilizing the Open Enrollment module) or Process Open Enrollment

The following procedures are for Districts who are NOT utilizing the open enrollment module. If you are utilizing the Open Enrollment module please review the procedures for Processing Open Enrollment Forms.

Go back to the List of Plans tab and change the date to the current date. In the first column, check the boxes for plans you wish to roll the staff members over, and click the “Rollover All Staff Healthcare Benefit Tracking Records to the next date that the rates change”  button. 

Review the screen and ENSURE the migration information is correct. YOU MUST CHANGE THE "OR THIS DATE" TO THE LAST DAY OF THE NEW PLAN YEAR. THIS IS THE SAME AS THE HEALTH TRACKING THRU DATE FROM THE THIRE ILLUSTRATION IN STEP 2.

Once thus date is set, click on the Rollover button.