Health Rate Year & Plan Year

Modified on Thu, Dec 28, 2023 at 9:08 AM

SchoolFi has two settings for all health plans to define the time period the heath plan is utilized for a staff member's health tracking record. They are:

Rate Year: The Rate Year is the time period that the District pays the premium to the provider for the insurance coverage. Typically, this is either a 12 month period or a 24 month period. There are circumstances where the rate year is a single month or any other number of consecutive months.

Plan Year: The plan year is the time period that the Heath Plan will be utilized to create a health tracking records in SchoolFi. The Plan Year MUST BE THE SAME for all health plans on the individuals' health tracking records. This is required for complete and accurate payroll deductions, 1095C forms and healthcare reports.

Setting the Rate Year & the Plan Year:

Navigate to the Personnel >>> Setup >>> Health Plans >>> List of Health plans. You will see the Rate Year Start and End columns, highlighted in red below. To enter the Rate Year, click on the Edit button.

In the pop up window, enter the Rate Start Date and the Rate End Date. Please note that this may, or may not, be the same as the Plan From Date and the Plan Through date.

Example of different Health Rate Year & Plan Year

A district’s Health and Prescription plans run on a calendar year basis (January 1 thru December 31) and their Dental plan runs on a fiscal year basis (July 1 thru June 30).  This is typical amongst Districts participating in the State Health Plan.

The following chart illustrates the difference between the Plan Year and the Rate Year.

The Rate Year is represented by the blue highlighted cells. The Plan Year is represented byt he red and purple bubbles.
The medical and prescription rates are the same from January 2024 through December 2024, so the Rate Year for the medical and prescription plans are set, accordingly (blue cells).
The dental rates are the same from July 2023 through June 2024, so the Rate Year for the dental plan is set, accordingly (blue cells).

The current Plan Year is 1/1/2024 through 6/30/2024 (red). The reason is that this is the current time period when all of the rates the District pays to all providers are consistent and the rates do not differ for any of the plans.
The NEXT Plan Year (purple) will be 7/1/24 through 12/31/2024. The reason is that the dental plan rates change for July 2024 and all of the rates do not differ for any of the other plans during the time period.

In this example, all staff members, who are employed for the entire period, will have two (2) heath tracking records for calendar year 2024. The first from 1/1/2024 through 6/30/2024 and the second from 7/1/24 through 12/31/2024. This is required for complete and accurate payroll deductions, 1095C forms, and healthcare reports.

Healthcare rollover (for the example): The District will perform 2 rollovers in calendar year 2024. This is REQUIRED to ensure that all staff members' health tracking records correspond with the respective plan years. When the rollover is processed, you will only update the rates for those plans whose premiums (rate year) changed for the rolled over Plan Year. 