HR325 - Benefits Administration PDF

HR 325 Benefits Administration
HR325
R/3 System Release 46C 05/02/2001
http://ebookssap.blogspot.com
0
HR 325 Benefits Administration...................................................................................................................................0-1
Copyright ..................................................................................................................................................................0-2
The R/3 Integration Model....................................................................................................................................0-3
Human Resources (1)............................................................................................................................................0-4
Prerequisites ..........................................................................................................................................................0-5
Target Group .........................................................................................................................................................0-6
Introduction...............................................................................................................................................................1-1
Course Goals .........................................................................................................................................................1-2
Course Objectives .................................................................................................................................................1-3
Contents ................................................................................................................................................................1-4
Contents (North America).....................................................................................................................................1-5
Course Overview Diagram....................................................................................................................................1-6
Course Overview Diagram (North America) ........................................................................................................1-7
Main Business Scenario ........................................................................................................................................1-8
Benefits Overview.....................................................................................................................................................2-1
Benefits Overview: Unit Objectives .....................................................................................................................2-2
Benefits Overview: Course Overview Diagram....................................................................................................2-3
Benefits Overview: Business Scenario .................................................................................................................2-4
Benefits Menu .......................................................................................................................................................2-5
Benefits Enrollment ..............................................................................................................................................2-6
Benefits Infotypes in Enrollment ..........................................................................................................................2-7
What Happens During the Enrollment Process? ...................................................................................................2-8
Master Data Infotype Requirements .....................................................................................................................2-9
New slide to replace this one follows (still screen shot)!Overview of current benefits ......................................2-10
Open enrollment..................................................................................................................................................2-11
Benefits Events ...................................................................................................................................................2-12
Monitoring of Eligibility During Participation ...................................................................................................2-13
Insurability ..........................................................................................................................................................2-14
Benefits Overview: Unit Summary .....................................................................................................................2-15
Basic Settings & Common Concepts ........................................................................................................................3-1
Basic Settings & Common Concepts: Unit Objectives .........................................................................................3-2
Basic Settings & Common Concepts: Course Overview Diagram .......................................................................3-3
Basic Settings & Common Concepts: Business Scenario .....................................................................................3-4
Benefits Customizing - IMG.................................................................................................................................3-5
Benefit Area ..........................................................................................................................................................3-6
Define Benefit Providers.......................................................................................................................................3-7
Benefit categories..................................................................................................................................................3-8
Plan Types.............................................................................................................................................................3-9
Category, Type and Plan in the Infotype.............................................................................................................3-10
Define Benefit Plan Statuses...............................................................................................................................3-11
Define Dependents and Beneficiaries .................................................................................................................3-12
Basic Settings & Common Concepts: Unit Summary........................................................................................3-13
Health Plans ..............................................................................................................................................................4-1
Health Plans: Unit Objectives ...............................................................................................................................4-2
Health Plans: Course Overview Diagram .............................................................................................................4-3
Health Plans: Business Scenario ...........................................................................................................................4-4
Health Plan Setup..................................................................................................................................................4-5
Define Health Plan General Data ..........................................................................................................................4-6
Health Plan Options and Dependent Coverage .....................................................................................................4-7
Formula and calculation rules ...............................................................................................................................4-8
Cost Variant, Grouping and Rule..........................................................................................................................4-9
Cost formula........................................................................................................................................................4-10
Cost Grouping Feature - CSTV1.........................................................................................................................4-11
Define Cost Grouping & Set up Feature .............................................................................................................4-12
Define Cost Variant ............................................................................................................................................4-13
Cost Rules ...........................................................................................................................................................4-14
Assign Health Plan Attributes .............................................................................................................................4-15
Evidence of Insurability (EOI) - Health ..............................................................................................................4-16
Define Evidence of Insurability Conditions........................................................................................................4-17
Evidence of Insurability on Infotype 0167 (Health)...........................................................................................4-18
Health Plans: Unit Summary...............................................................................................................................4-19
Insurance Plans .........................................................................................................................................................5-1
Insurance Plans: Unit Objectives ..........................................................................................................................5-2
Insurance Plans: Course Overview Diagram.........................................................................................................5-3
Insurance Plans: Business Scenario ......................................................................................................................5-4
- .............................................................................................................................................................................5-5
- .............................................................................................................................................................................5-6
Define Insurance Plan General Data .....................................................................................................................5-7
Coverage Variant, Grouping and Rule ..................................................................................................................5-8
Coverage Grouping Feature - COVGR.................................................................................................................5-9
Insurance Plans ...................................................................................................................................................5-10
Coverage Rules ...................................................................................................................................................5-11
Define Coverage Rule .........................................................................................................................................5-12
Cost formula........................................................................................................................................................5-13
Cost formula........................................................................................................................................................5-14
Cost group feature...............................................................................................................................................5-15
Cost group feature...............................................................................................................................................5-16
Define Cost Variant ............................................................................................................................................5-17
Cost Rules ...........................................................................................................................................................5-18
Define Cost Rule.................................................................................................................................................5-19
Step Limits ..........................................................................................................................................................5-20
Assign Insurance Plan Attributes ........................................................................................................................5-21
Evidence of Insurability (EOI) - Insurance .........................................................................................................5-22
Define Evidence of Insurability Conditions........................................................................................................5-23
Evidence of Insurability on Infotype 0168..........................................................................................................5-24
Combined Coverage Limits ................................................................................................................................5-25
Combined Coverage for Insurance I ...................................................................................................................5-26
Combined Coverage for Insurance II ..................................................................................................................5-27
Insurance Plans: Unit Summary..........................................................................................................................5-28
Savings Plans ............................................................................................................................................................6-1
Savings Plans: Unit Objectives .............................................................................................................................6-2
Savings Plans: Course Overview Diagram ...........................................................................................................6-3
Savings Plans: Business Scenario .........................................................................................................................6-4
- .............................................................................................................................................................................6-5
Savings Plans ........................................................................................................................................................6-6
Savings Plan Overview - Four Components .........................................................................................................6-7
Employee Contribution Variant, Grouping and Rule............................................................................................6-8
Employee Contribution Grouping Feature - EECGR............................................................................................6-9
Define EE Contribution Grouping & Set up Feature ..........................................................................................6-10
Define Employee Contribution Rule...................................................................................................................6-11
Employer Contribution Variant, Grouping and Rule ..........................................................................................6-12
Employer contribution group feature ..................................................................................................................6-13
Employer contribution group feature ..................................................................................................................6-14
Employer contribution rule criteria .....................................................................................................................6-15
Employer matching .............................................................................................................................................6-16
Vesting rule and schedule ...................................................................................................................................6-17
Investment groups ...............................................................................................................................................6-18
Assign savings plan attributes .............................................................................................................................6-19
Combined contribution limits .............................................................................................................................6-20
Combined Contribution Limits for Savings ........................................................................................................6-21
Combined Contribution Limits for Savings ........................................................................................................6-22
Savings plans: Unit Summary .............................................................................................................................6-23
Flexible Spending Accounts (FSAs - North America)..............................................................................................7-1
FSAs: Unit Objectives...........................................................................................................................................7-2
FSAs: Course Overview Diagram (North America) .............................................................................................7-3
FSAs: Business Scenario.......................................................................................................................................7-4
FSA Setup .............................................................................................................................................................7-5
Flexible Spending Accounts (FSAs) .....................................................................................................................7-6
Define FSA General Data .....................................................................................................................................7-7
Employer Contribution Variant, Grouping and Rule ............................................................................................7-8
Assign FSA Attributes ..........................................................................................................................................7-9
Define Receipt Types for FSA Claims Processing..............................................................................................7-10
FSA claims processing........................................................................................................................................7-11
FSAs: Unit Summary ..........................................................................................................................................7-12
Credit Plans...............................................................................................................................................................8-1
Credit Plans: Unit Objectives................................................................................................................................8-2
Credit Plans: Course Overview Diagram ..............................................................................................................8-3
Credit Plans: Business Scenario............................................................................................................................8-4
Credit Plan Setup ..................................................................................................................................................8-5
Define Credit Plan General Data...........................................................................................................................8-6
Credit Variant, Grouping and Rule .......................................................................................................................8-7
Credit Grouping Feature - CRDV1 .......................................................................................................................8-8
Define Credit Grouping & Set up Feature............................................................................................................8-9
Credit Rules ........................................................................................................................................................8-10
Assign Credit Plan Attributes..............................................................................................................................8-11
Credit Examples..................................................................................................................................................8-12
Credit Plans: Unit Summary ...............................................................................................................................8-13
Miscellaneous Plans..................................................................................................................................................9-1
Miscellaneous Plans: Unit Objectives...................................................................................................................9-2
Course Overview Diagram....................................................................................................................................9-3
Miscellaneous Plans: Business Scenario...............................................................................................................9-4
Miscellaneous Plan Setup .....................................................................................................................................9-5
Define Miscellaneous Plan General Data..............................................................................................................9-6
Two kinds of miscellaneous plans ........................................................................................................................9-7
Miscellaneous Plans - Example.............................................................................................................................9-8
Miscellaneous Plans - Example (Cont.) ................................................................................................................9-9
Assign miscellaneous plan attributes ..................................................................................................................9-10
Miscellaneous Plans: Unit Summary ..................................................................................................................9-11
Flexible Administration ..........................................................................................................................................10-1
Flexible Administration: Unit Objectives ...........................................................................................................10-2
Flexible Administration: Course Overview Diagram..........................................................................................10-3
Pre- and Corequisite Plans: Topic Objectives .....................................................................................................10-4
Pre- and Corequisite Plans: Business Scenario ...................................................................................................10-5
Prerequisite and Corequisite Plans......................................................................................................................10-6
Define Prerequisite and Corequisite Plan............................................................................................................10-7
Programs, Eligibility, Termination: Topic Objectives ........................................................................................10-8
Programs, Eligibility, Termination: Business Scenario ......................................................................................10-9
First Program Grouping Feature - BENGR.......................................................................................................10-10
Define First Program Grouping & Set up Feature.............................................................................................10-11
Second Program Grouping Feature - BSTAT ...................................................................................................10-12
Define Second Program Grouping & Set up Feature ........................................................................................10-13
Macro Eligibility: Programs.............................................................................................................................10-14
Micro Eligibility: Variant and Grouping Definitions........................................................................................10-15
Define Eligibility Grouping & Set Up Feature .................................................................................................10-16
Eligibility Rule..................................................................................................................................................10-17
Macro Eligibility Linked to Micro Eligibility...................................................................................................10-18
Termination is Eligibilitys Mirror Image ........................................................................................................10-19
Termination: Variant and Grouping Definitions ...............................................................................................10-20
Define Termination Grouping & Define Feature ..............................................................................................10-21
Termination Rule ..............................................................................................................................................10-22
Termination Variant in the Program .................................................................................................................10-23
Eligibility and Termination Variants in the Program ........................................................................................10-24
Standard Plans: Topic Objectives .....................................................................................................................10-25
Standard Plans: Business Scenario....................................................................................................................10-26
Standard Plans...................................................................................................................................................10-27
Define Standard Plan and Standard Plans Overview ........................................................................................10-28
Adjustment Reasons: Topic Objectives ............................................................................................................10-29
Adjustment Reasons: Business Scenario...........................................................................................................10-30
Adjustment Reasons and Adjustment Offer......................................................................................................10-31
Adjustment Grouping Feature - EVTGR ..........................................................................................................10-32
Event group feature ...........................................................................................................................................10-33
Define Adjustment Grouping & Set Up Feature ...............................................................................................10-34
Adjustment Permissions....................................................................................................................................10-35
Define Adjustment Permissions ........................................................................................................................10-36
Administrative Parameters: Topic Objectives...................................................................................................10-37
Administrative Parameters: Business Scenario .................................................................................................10-38
Parameters for open and event offers ................................................................................................................10-39
Administrative Parameters for Benefit Area .....................................................................................................10-40
Flexible Administration: Unit Summary...........................................................................................................10-41
COBRA (USA) .......................................................................................................................................................11-1
COBRA: Unit Objectives....................................................................................................................................11-2
COBRA: Course Overview Diagram (USA) ......................................................................................................11-3
COBRA: Business Scenario................................................................................................................................11-4
COBRA Qualifying Event System Criteria.........................................................................................................11-5
Assign COBRA Events to Personnel Actions.....................................................................................................11-6
Choose COBRA Plans ........................................................................................................................................11-7
Define Qualifying Event Coverage Periods ........................................................................................................11-8
Define Notification and Payment Intervals .........................................................................................................11-9
Define Processing Parameters...........................................................................................................................11-10
Define Early Termination Reasons ...................................................................................................................11-11
COBRA: Unit Summary ...................................................................................................................................11-12
Benefits Processing .................................................................................................................................................12-1
Benefits Processing: Unit Objectives..................................................................................................................12-2
Benefits Processing: Course Overview Diagram ................................................................................................12-3
Benefits Processing: Business Scenario ..............................................................................................................12-4
Enrollment II .......................................................................................................................................................12-5
Open offer processing .........................................................................................................................................12-6
Eligibility ............................................................................................................................................................12-7
Insurability ..........................................................................................................................................................12-8
Termination.........................................................................................................................................................12-9
Benefits Processing: Unit Summary .................................................................................................................12-10
Benefits Processing (North America) ....................................................................................................................13-1
Benefits Processing (North America): Unit Objectives ......................................................................................13-2
Benefits Processing (North America): Course Overview Diagram.....................................................................13-3
Benefits Processing (NA): Business Scenario.....................................................................................................13-4
Flexible Spending Accounts (North America) ....................................................................................................13-5
FSA Claims Processing I ....................................................................................................................................13-6
FSA Claims Processing II ...................................................................................................................................13-7
COBRA Administration I ...................................................................................................................................13-8
COBRA Administration II ..................................................................................................................................13-9
COBRA Administration III...............................................................................................................................13-10
COBRA Administration Menu..........................................................................................................................13-11
Benefits Processing (NA): Unit Summary ........................................................................................................13-12
Reporting & Customizing Tools .............................................................................................................................14-1
Reporting & Customizing Tools: Unit Objectives ..............................................................................................14-2
Reporting & Customizing Tools: Course Overview Diagram ............................................................................14-3
Reporting & Customizing Tools: Business Scenario ..........................................................................................14-4
Two types of Benefits reports .............................................................................................................................14-5
Employee data analysis reports ...........................................................................................................................14-6
Example: Insurance Plan Costs Report ...............................................................................................................14-7
Plan Overview.....................................................................................................................................................14-8
Plan Cost Summary.............................................................................................................................................14-9
Configuration Consistency Check.....................................................................................................................14-10
Copy/Delete Benefit Area/Benefit Plan ............................................................................................................14-11
- .........................................................................................................................................................................14-12
Reporting & Customizing Tools: Unit Summary..............................................................................................14-13
Payroll Integration: Contents ..................................................................................................................................15-1
Payroll integration: Unit Objectives....................................................................................................................15-2
Course Diagram ..................................................................................................................................................15-3
Payroll integration: Business Scenario................................................................................................................15-4
Points of Integration to Payroll ...........................................................................................................................15-5
Remittance to Benefit Providers .........................................................................................................................15-6
Wage Types - health plans ..................................................................................................................................15-7
Wage Types - insurance plans.............................................................................................................................15-8
Wage Types - savings plans ................................................................................................................................15-9
Wage Types - FSAs (USA only).......................................................................................................................15-10
Wage Types - credit plans.................................................................................................................................15-11
Wage Types - miscellaneous plans ...................................................................................................................15-12
Payroll integration: Unit Summary ...................................................................................................................15-13
- ...............................................................................................................................................................................16-1
- ...............................................................................................................................................................................17-1
Appendix.................................................................................................................................................................18-1
Main Benefits IMG Paths in 4.6..........................................................................................................................18-2
HR 325 Benefits Administration
HR325
Benefits Administration
SAP AG 1999
SAP AG
R/3
Release 4.6A
November 1999
Material number 5003 4899
Copyright
Copyright 1999 SAP AG. All rights reserved.
Neither this training manual nor any part thereof may

be copied or reproduced in any form or by any means,
or translated into another language, without the prior
consent of SAP AG. The information contained in this
document is subject to change and supplement without
prior notice.
All rights reserved.
SAP AG 1999
Trademarks
SAP and the SAP logo are registered trademarks of SAP AG.
MS-DOS and EXCEL are registered trademarks of Microsoft.
OS/2, CICS, MVS, ACF/VTAM, VSE, AIX, OS/400 and AS/400 are registered trademarks of IBM.
X Window System is a registered trademark of MIT University.
SINIX, UTM and BS2000 are registered trademarks of Siemens.
UNIX is a registered trademark of AT&T.
HP-UX is a registered trademark of Hewlett Packard.
DECnet, DECstation, DECsystem, VAXstation and VMS are registered trademarks of DEC.
Ethernet is a registered trademark of the Xerox Corporation.
ORACLE SQL*net, SQL*+ PRO*C are registered trademarks of the ORACLE Corporation.
INFORMIX-OnLine and INFORMIX-ESQL/C are registered trademarks of the INFORMIX
Corporation.
The R/3 Integration Model
SD FI
Sales & Financial
Distribution Accounting
MM CO
Materials Controlling
Mgmt.
PP AA
Production Asset
Planning
R/3 Accounting
QM
Quality
Client / Server Project
PS
Mgmt. PM
Plant
ABAP WF
System
Maintenance Workflow
HR IS
Human Industry
Resources Solutions
SAP AG 1999
SAPs R/3 System has set new norms for standard software that can be universally implemented. R/3
uses advanced development techniques to achieve comprehensive integration of business administration
and data processing.
R/3 combines state-of-the-art technology with comprehensive business administration functions to
provide a fully-integrated business solution for your company.
Human Resources (1)
Level 2 Level 3
HR510 2 days
Personnel Development
HR505 3 days HR515 3 days
Organizational Training and Event
Management Management
HR305 3 days HR306 2 days HR520 2 days
Configuration of Master Configuration of Time
Data Shift- and Workforce
Recording Planning
HR315 3 days HR310/311 4 days
Recruitment (see Time Evaluation
HR050 5 days HR2)
Human Resources HR307 2 days
AC270 3 days Configuration of HR-
Administration &
Travel Management Security
Compensation Programming in HR

Benefits Administration Technical topics in HR
HR550 2 days
Human Resources & CA500 2 days
Business Workflow CATS Cross Application
TimeSheets
SAP AG 1999
Prerequisites
z Required:
HR050 Human Resources Management
HR305 Configuration of Master Data
SAP AG 1999
Target Group
z Benefits implementation project team

members
z SAP consultants and partners working with
SAP HR clients
SAP AG 1999
Introduction
Contents:
z Course Goals
z Course Objectives
z Course Content
z Course Overview Diagram
z Main Business Scenario
SAP AG 1999
(C) SAP AG HR325 1-1

Course Goals
This course will enable you to:

z Learn how to configure the Benefits system to
accommodate your Benefits business processes.
SAP AG 1999

Course Objectives
At the conclusion of this course, you will be able to:
z Configure the Benefits system.

z Explain and perform the Benefits business
processes.
SAP AG 1999

Contents
Preface
Unit 1 Introduction Unit 8 Credit Plans
Unit 2 Benefits Overview Unit 9 Miscellaneous Plans
Unit 3 Basic Settings and Unit 10 Flexible Administration
Common Concepts
Unit 11 Benefits Processing
Unit 4 Health Plans
Unit 12 Reporting &
Unit 5 Insurance Plans Customizing Tools
Unit 6 Savings Plans Unit 13 Payroll Integration

Unit 7 Stock Purchase Plans
Exercises
Solutions
Appendix
SAP AG 1999

Contents (North America)
Preface
Unit 1 Introduction Unit 9 Credit Plans
Unit 2 Benefits Overview Unit 10 Miscellaneous Plans
Unit 3 Basic Settings and Unit 11 Flexible Administration
Common Concepts Unit 12 COBRA (USA)
Unit 4 Health Plans Unit 13 Benefits Processing
Unit 5 Insurance Plans Unit 14 Benefits Processing
Unit 6 Savings Plans (North America)
Unit 7 Stock Purchase Plans Unit 15 Reporting &
Customizing Tools
Unit 8 Flexible Spending
Accounts (North America) Unit 16 Payroll Integration
Exercises
Solutions
Appendix
SAP AG 1999

Course Overview Diagram
Basic Settings
Benefits Health Insurance Savings
and Common
Overview Plans Plans Plans
Concepts
Stock
Credit Miscellaneous Flexible Benefits
Purchase
Plans Plans Administration Processing
Plans
Reporting &
Payroll
Customizing
Integration
Tools
SAP AG 1999

Course Overview Diagram (North America)
Basic
Benefits Settings & Health Insurance Savings
Overview Common Plans Plans Plans
Concepts
Flexible
Stock Spending
Credit Miscellaneous Flexible
Purchase Accounts
Plans Plans Administration
Plans (North
America)
Benefits Reporting &

COBRA Benefits Processing Payroll
Customizing
(USA) Processing (North Integration
Tools
America)
SAP AG 1999

Main Business Scenario
z Your company is implementing new benefit plans to

make the company more attractive to prospective
employees, and to retain good employees already
within the company.
z You need to accommodate your companys benefits
in the SAP Benefits system.
z Then you must demonstrate to your benefits
administrator how SAP Benefits can streamline work
processes.
SAP AG 1999

Benefits Overview
Contents:
z Plan categories
z Benefits menu
z Infotypes
z Benefits processing
SAP AG 1999

Benefits Overview: Unit Objectives
At the conclusion of this unit, you will be able to:
z List the benefit plan categories.

z List infotypes relevant to Benefits.
z List the main benefits processes handled by the SAP
Benefits system:
Enrollment
Termination
Eligibility
Insurability
Overview
Cost summary
SAP AG 1999

Benefits Overview: Course Overview Diagram
Basic
Concepts
Flexible
Stock Spending
Purchase Accounts
Plans (North
America)

Customizing
Tools
America)
SAP AG 1999

Benefits Overview: Business Scenario
z Your company is implementing new benefit

plans to make the company more attractive to
prospective employees and to retain good
employees already in the company.
z You need to see how the different categories of
benefits are accommodated in the SAP Benefits
system, and how the benefits processes are
streamlined.
SAP AG 1999

Benefits Menu
R3 Main Menu
Human resources
Personnel management Administration
Time management Recruitment
Payroll Personnel development
Training and events Benefits
Organizational management Compensation management
Travel management Personnel costs
Information system
Benefits
Current benefits Open offer Event offer Eligibility Insurability
SAP AG
Benefits is a component of Personnel Management and is found below it in the SAP R/3 menu.

Benefits Enrollment
Enrollment
Human Resources
Enroll
Managers Desktop
Direct selection Open offer for
Personnel management
Benefits Personnel number 4401 Rose Salizar on 01.12.1999
Enrollment
BenArea
Enrollment period
1stProGrp.
Flex Credits
Flex Credit Plan 1 01.03.2000-31.12.2000
2ndProGrp. Dental
Standard Dental Plan 01.01.2000-31.12.2000
on 15.11.1999 Medical
Medical Plan 1 01.01.2000-31.12.2000
Add Replace
Medical for Singles 01.01.2000-31.12.2000
Offer selection Life Insurance
Standard Life Insurance 01.01.2000-31.12.2000
Pers.no. Name Suppl. Life
Please choose an offer:
Suppl. Life Insurance 01.01.2000-31.12.2000
4401 Rose Salizar
Savings
Open offer
7006 Albert Leroux Standard Savings Plan 01.01.2000-31.12.2000
Default offer Stock Purchase
10721 Karen Holtzblatt Alternative Stock Purchase 01.01.2000-31.12.2000
Automatic offer Standard Stock Purch. Plan 01.01.2000-31.12.2000
32599200 Guido Loersch Dependent Care
Always avail. offer Dependent Care 01.01.2000-31.12.2000
Initial enrollment 32599300 Ben Waltham Company Car
Company Car 01.03.2000-31.12.2000
Birth of child Fitness Plan
Fitness club membership 01.01.2000-31.12.2000
SAP AG 1999
Under Enrollment, you have to specify an offer type before you get the list of all plans offered for an
employee.
As you enroll each employee, the system automatically presents only those plans for which the employee
is eligible.
The system also calculates the cost of the plan options, which can vary for each employee.

Benefits Infotypes in Enrollment
Used
Used for
for enrollment
enrollment Created
Created by
by enrollment
enrollment Additional
Additional records
records
General
General Benefits
Benefits Data
Data Health
Health Plans
Plans Family/Related
Family/Related Person
Person
(IT
(IT 0171)
0171) (IT
(IT 0167)
0167) (IT
(IT 0021)
0021)
Adjustment
Adjustment Reasons
Reasons Insurance
Insurance Plans
Plans External
External Organizations
Organizations
(IT
(IT 0378)
0378) (IT
(IT 0168)
0168) (IT
(IT 0219)
0219)
Benefits
Benefits Medical
Medical Data
Data Savings
Savings Plans
Plans Monitoring
Monitoring of
of Dates
Dates
(IT
(IT 0376)
0376) (IT
(IT 0169)
0169) (IT 0019)
(IT 0019)
Additional
Additional Personal
Personal Stock
Stock Purchase
Purchase Plans
Plans Date
Date Specifications
Specifications
Data
Data (USA
(USA only)
only) (IT
(IT 0379)
0379) (IT
(IT 0041)
0041)
(IT
(IT 0077)
0077)
Credit
Credit Plans
Plans HCE
HCE Information
Information
(IT
(IT 0236)
0236) (IT
(IT 0375)
0375) (USA)
(USA)
Miscellaneous
Miscellaneous Plans
Plans
(IT 0377)
(IT 0377)
...
...
FSA
FSA (IT
(IT 0170)
0170) (NA)
(NA)
FSA
FSA Claims (IT
Claims (IT 0172)
0172) (NA)
(NA)
SAP AG 1999
The benefits infotypes used for enrollment must be in place before enrollment takes place, depending on
the type of enrollment. General benefits data (Infotype 0171) contains essential employee information
including Benefit area, First program grouping and Second program grouping.
Master data infotypes Actions (0000), Organizational Assignment (0001), Personal Data (0002) and
possibly Basic Pay (0008) are also required for enrollment.
You can directly access the additional infotype records from the benefits enrollment screen and display,
change or create data.

What Happens During the Enrollment Process?
Adjustment Reasons Offer Benefit plan DENT

(IT 0378)
General Benefits Benefit plan LIFE
Data (IT 0171)
Personal Data Benefit plan MED1
(IT 0002) Plan selection
Provider
Org. Assignment
(IT 0001) Plan Data
Regulatory reports
Actions
Attributes
(IT 0000)
Consistency check Wage types
Personnel event
Status Benefit
Benefit plan
plan
Organizational
... setup
setup in
in IMG
IMG
assignment
Master
Master data
data Credit Plan Savings Plan
and benefits
and benefits ...
(IT 0236) (IT 0169)
Miscellaneous Plan
infotype
infotype records
records (IT 0377)
Stock Purchase Plan
(IT 0379)
Insurance Plan Flexible Spending
(IT 0168) Account (IT 0170)
Plan data Health Plan
Plan dates (IT 0167)
Employee data Plan data
Plan attributes Plan dates Creation
Creation of
of new
new plans
plans
Benefits salary/ Employee data
coverage (annual) Plan attributes
Cost Cost
SAP AG 1999
Enrollment requires employee master data records and benefit plan data to enroll the employee in
benefit plans.
The benefit plan infotype records are created by the enrollment process. You only need to select the plan
options for the employee, and the infotype records are created automatically by the system.
Note: Plans in which the employee is already participating, are considered in the offer as well.
Note: In the enrollment process, you do not only create plans for employees, but you can also stop the
participation in an existing plan in the given time period.

Master Data Infotype Requirements
0000
0000 Actions
Actions
0001
0001 Org.
Org. Assignment employee
employee must
must exist
exist
Assignment
0002
0002 Personal
Personal Data
Data

0008
0008 Basic
Basic pay
pay
cost,
cost, coverage,
coverage, credit
credit and
and
0014
0014 Recur.
Recur. Payments/Deds
Payments/Deds..
Payments/Deds. benefit salary calculations
benefit salary calculations
0015
0015 Additional
Additional Payments
Payments
0001
0001 Org.
Org. Assignment
Assignment benefit
benefit area,
area,
0007
0007 Planned
Planned Working
Working Time
Time first
first program grouping,
program grouping,
0057 Membership Fees second
second program
program grouping,
grouping,
0057 Membership Fees
adjustment
adjustment grouping
grouping
0094
0094 Residence
Residence Status
Status
cost
cost grouping,
grouping,
0001,
0001, 0002,
0002, 0008,
0008, 0057,
0057, 0094
0094 coverage
coverage grouping
grouping
0077
0077 Addit.
Addit.. Personal
Addit Personal Data
Data EE
EE and
and ERER contribution
contribution grouping,
grouping,
0006
0006 Addresses
Addresses credit grouping,
credit grouping,
0007 eligibility
eligibility grouping
grouping
0007 Planned Working
Planned Working Time
Time
zip
zip code
code eligibility
eligibility
0021
0021 Family/Related
Family/Related Person
Person related
related person
person group
group
0000
0000 Actions
Actions termination
termination grouping
grouping
SAP AG 1999
The first three master data infotypes above must exist in the system before benefits processing can take
place.
Depending on the way your system is implemented, the system requires certain other employee
infotypes in order to calculate the elements listed above.

New slide to replace this one follows (still screen
shot)!Overview of current benefits
Current benefits
Participated as of 01/04/19XX
10 Benefit area
00004490 Ms Marita Bond
Flex credit plan 01011998 -31121998
Credit
Employer 250.00 USD monthly
Standard dental 01011998 -31121998
Attributes
Attributes
Option 1
Costs
Costs
Employee 33.33 USD monthly
Medical plan 1 01011998 -31121998
Standard saving 01011998 -31121998
Company car 01011998 -31121998
Reserve account 01011998 -31121998
SAP AG 1999
The current benefits display the enrollment of an employee.

Details of options, cost, coverage, contributions etc are also displayed.
(C) SAP AG HR325 2-10

Open enrollment
Employee
Open offer Employee Employee

is created makes is enrolled
for the benefits in benefit
employee choices plans
SAP AG
The open offer processes employees during the open enrollment period.
This is usually the time period in which current employees are permitted to change from one plan to
another without requiring that a qualifying event has occurred, such as a change in marital status or a
new dependent.
(C) SAP AG HR325 2-11

Benefits Events
Change
Change
New
New hire
hire savings
savings Marriage
Marriage Job
Job change
change New
New child
child
contribution
contribution
Time
SAP AG
The event offer processes employees who have experienced a benefits event and want to change their
benefits choices.
(C) SAP AG HR325 2-12

Monitoring of Eligibility During Participation
Eligibility: Overview
Stop participation
Validity Reason for ineligibility
Eligibility check 17.08.1999

99 Internation. Basic
4401 Rose Salizar
Medical Plan 2 01.01.1999-31.12.1999 Address (type Home address) of employee does not exist
4411 Chris Smith
Stand. Dental Plan 01.01.1999-31.12.1999 Employee 4411 is not enrolled in all corequisite plans for DENT
Medical Plan 1 01.01.1999-31.12.1999 Employee 4411 is not enrolled in all corequisite plans for MED1
4412 Alan Miller
Savings Plan 01.01.1999-31.12.1999 Required number of actual working hours for eligibility not reached
4413 Peter Banks
Stand. Dental Plan 01.01.1999-31.12.1999 Employee 4411 is not enrolled in all corequisite plans for DENT
Medical Plan 1 01.01.1999-31.12.1999 Employee 4411 is not enrolled in all corequisite plans for MED1
SAP AG 1999
Once employees are participating in plans, you can check that they continue to fulfill all eligibility
criteria for the plans.
The system checks:
y Is the plan in program?
y Is eligibility rule fulfilled (e.g. waiting period, min. working time, min./max. age, zip code)?
y Are corequisites fulfilled?
(C) SAP AG HR325 2-13

Insurability
Insurability: Overview
Insurability proven Stop participation
Status Option End of grace period Period
Insurability on 08.09.1999
4401 Rose Salizar
Medical Plan 2 Option 2 09.05.1999 01.01.2000 - 31.12.2000
4411 Chris Smith
Standard Life Ins. Coverage Level 1 Proven 01.01.1999 - 31.12.1999
Medical Plan 2 Option 2 09.05.1999 01.01.2000 - 31.12.2000
4412 Alan Miller
Altern. Life Ins. Coverage Level 2 01.12.1999 01.10.1999 - 31.12.1999
4413 Peter Banks
Stand. Life Ins. Coverage Level 1 01.08.1999 01.01.1999 - 30.09.1999
Altern. Life Ins. Coverage Level 2 01.10.1999 01.10.1999 - 27.12.1999
Record is locked
Active
Pending
Insurability proven
Grace period expired
Insurability not proven
SAP AG 1999
Before employees can participate in some insurance and health plans, they must often provide Evidence
of Insurability (EOI) such as a medical affidavit for proof of good health.
You can further manage EOI by terminating employee enrollments, when the employee has not provided
EOI within the grace period.
(C) SAP AG HR325 2-14

Benefits Overview: Unit Summary
You are now able to:

z List the benefit plan categories
within the system.
z List infotypes relevant to Benefits.
z List the main benefits processes
handled by the SAP Benefits system:
Enrollment
Termination
Eligibility
Insurability
Overview
Cost summary
SAP AG 1999
(C) SAP AG HR325 2-15

Basic Settings & Common Concepts
Contents:
z Basic Settings
Benefit area
Plan types
Providers
Dependents/beneficiaries
Plan statuses
z Common Concepts
Variants and Rules
Evidence of insurability
Calculation base date and cutoff date
Date override
SAP AG 1999

Basic Settings & Common Concepts:
Unit Objectives
z Describe the concept of benefit areas.

z Describe the concept of plan types.
z Define basic settings needed for your benefits
configuration.
z Describe common concepts used throughout
the benefits system.
SAP AG 1999

Basic
Concepts
Flexible
Stock Spending
Purchase Accounts
Plans (North
America)

Customizing
Tools
America)
SAP AG 1999

Business Scenario
z Your company has several different

benefit plans which need to be organized for
configuration in the SAP Benefits system.
You now have to make basic settings and define
benefit area, currency, providers,
dependents/beneficiaries, plan types and statuses.
SAP AG 1999

Benefits Customizing - IMG
Basic Settings
Define Benefit Areas
Assign Currency to Benefit Area
Define Benefit Providers Always
Always make
make sure
sure you
you
Set Current Benefit Area
work
work in the correct benefit
in the correct benefit area.
area.
Dependents and Beneficiaries
Define Dependents and Beneficiaries
Define Dependent/Beneficiary Groups
Plan Attributes
Define Benefit Plan Types
Define Benefit Plan Status
Define Employee Groupings
Define Employee Criteria Groups
Define Cost Groupings
Define Credit Groupings
Define Coverage Groupings
Define Employee Contribution Groupings
Define Employer Contribution Groupings
Plans
Flexible Administration
COBRA
Toolset
You are currently working in benefit area 99
SAP AG 1999
The benefits implementation guide (IMG) can be found under Personnel Management in the SAP
Refererence IMG via Tools AcceleratedSAP Customizing Project management SAP
Reference IMG.
This topic covers the Basic settings part of the Benefits IMG except the Define employee groupings
node. This will be covered at the relevant points during the course.
If you have more than one benefit area to set up, you must set up each independently. After you have set
up all the plans in one area, you must return to the Set current benefit area view and set the next current
benefit area and work through the IMG again, setting up the new benefit area. Always make sure you
work in the correct benefit area by setting the relevant benefit area for your customizing activities in this
view.

Benefit Area
First
First sub-division
sub-division of
of benefit
benefit information:
information: Independent
Independent administration
administration

by
by currency
currency
Benefit
Benefit area
area 01
01
Benefit
Benefit area
area 04
04
Benefit
Benefit area
area 02
02
Benefit
Benefit area
area 05
05
Benefit
Benefit area
area 03
03

by
by benefit
benefit plan
plan pool
pool ...
...

by
by subsidiary
subsidiary
M
M
SAP AG 1999
A benefit area must be administered in one currency. In the case of a currency switch, however, the
conversion from one currency to another is supported by the system. Therefore, you use the reports
Currency conversion and Currency conversion of infotypes. These reports can be found in the Benefits
IMG under Toolset.
If groups of employees have very different benefit plan pools, you can set up a benefit area for each
benefit plan pool.
If your company has different subsidiaries, you can also set up a benefit area for each subsidiary.
Benefit areas allow separate administration of independent benefit plan pools.
You can also create separate IMG projects for the setup of each benefit area.

Define Benefit Providers
Change View Benefit Plan Type: Overview
HR payee 00000001 Prudential Insurance
Provider number 00000000042
SponsorId SAPCUSTOMTT
Vendor VEND5 Link

Link to
to Financial
Financial Accounting
Accounting
Primary contact
Name Mr. James OBrien
Telephone (617) 345-5838
Fax (617) 345-1000
Secondary contact
Name Ms. Nancy Clinton
Telephone (617) 345-6729
Fax (617) 345-1000
Additional contact
Name Mr. Louis Valls
SAP AG 1999
A benefit provider is the vendor or carrier of a benefit plan.

The list of benefit providers is valid for all benefit areas that you subsequently define.
The sponsor identification number is the indentifier the provider uses for your company. It is included in
the IDOC transmission file sent to the provider.
Vendor information is set up in Financial Accounting and referenced within the Benefits IMG.

Benefit categories
Health Insurance Savings Credit Miscellaneous Spending

Accounts
$ (USA only)
5% interest
SAP AG
There are five international benefit categories. These are the Health. Insurance, Savings, Credit and
Miscellaneous categories.
There is one USA specific benefit category. It is the Spending Accounts category.
The category defines the attributes of a plan. This determines how the plans are set up in the IMG and
how employees are enrolled in the plans.

Plan Types
Category
Health
Health Insurance
Insurance Savings
Savings Miscellaneous
Miscellaneous
Type
MEDI
MEDI DENT
DENT LIFE
LIFE ALIF
ALIF LTSV
LTSV LEIS
LEIS CAR
CAR
Plan
MED1
MED1 HMO1
HMO1 DENT
DENT LIF1
LIF1 LIF2
LIF2 ALIF
ALIF SAV1
SAV1 FIT1
FIT1 SPRT
SPRT LXRY
LXRY
OR
Change View Benefit Plan Type: Overview
Plan type Text Plan category Text

LTSV Long Term Sav. C Savings plan
CAR Company Car E Miscellaneous plan
DENT Dental
Dental A Health plan
STPC Stock Purchase F Stock purchase plan
LIFE Life Insurance B Insurance plan
CRED Flex Credits 1 Credit plan
SAP AG 1999
Plan types are the subdivisions of the benefit plan categories.

The categories are defined by SAP. Plan types and plans can be customized.
You define plan types in the Benefits IMG step Define plan types under Plan attributes.
Note:
The system allows employees to be enrolled in only one plan per plan type at the same time.

Category, Type and Plan in the Infotype
Infotype Edit Goto Extras View Sy

System Help
Infotype Category Display Health Plans
Personnel no 1135 Berta B...

Name
EE group 1 Active employee 3400 Boston

Personnel area
X0 Salaried employee 112-23-3445

EE subgroup SSN
03.08.1999 to 31.12.9999 Chng 03.08.1999 Fusser
From
DENT Standard Dental Plan

Plan
Plan data Administr. Costs Dependents Addl data
General plan data

Benefit area 99 Internation. Basic
Subtype Plan type Plan type DENT Dental
Benefit plan DENT Standard Dental Plan
Health plan option OPT1 Option 1
Plan EEs plan Dependent coverage EE Employee only
Plan Parameter
Cost rule variant DCOS Dental Cost
SAP AG 1999
The category determines which infotype is created by the system when an employee is enrolled in a
plan:
y Health Plans (IT 0167)
y Insurance Plans (IT 0168)
y Savings Plans (IT 0169)
y Stock Purchase Plans (IT 0379)
y Credit Plans (IT 0236)
y Miscellaneous Plans (IT 0377)
y Flexible Spending Account/FSA (IT 0170) - North America only
The plan type defines the subtype of this record.
(C) SAP AG HR325 3-10

Define Benefit Plan Statuses
Table view Edit Goto Selection criteria Utilities System Help
Change View Benefit Plan Status: Overview
Plan Status Text Active Enroll

OP Open
LO Locked
CL Closed
Here,
Here, you
you choose
choose what
what the
the
defined plan status means.
defined plan status means.
SAP AG 1999
The plan status defines whether a plan is active and whether employees can currently enroll in the plan.
This information is used later, when you define benefit plans.
Possible statuses might be Closed, Open and Locked.
(C) SAP AG HR325 3-11

Define Dependents and Beneficiaries
Table view Edit Goto Selection criteria Utilities System Help
Change View Benefits Allowed Dependents/Beneficiaries: Overview
STyp Name Dependent Beneficiary

1 Spouse
10 Divorced spouse Here,
Here, you
you define
define which
which
2 Child subtypes
subtypes ofof infotype
infotype 0021
0021
are
are allowed
allowed asas dependents
dependents
3 Legal guardian
or
or beneficiaries
beneficiaries or
or both.
both.
4 Testator
5 Guardian
6 Stepchild
7 Emergency contact
8 Related persons
SAP AG 1999
During enrollment, the system allows you to select certain members of the employee's family or related
persons as dependents and beneficiaries. In order to be selected, these types of individuals must be
selected here. The possible selections here are the subtypes of Family/related person (Infotype 0021)
records.
This screen is customized once for all plans within a benefit area. Information that you enter here is
valid for all health, insurance, savings, stock purchase and miscellaneous plans.
This screen determines which subtypes from the Family/related persons infotype (0021) are valid as:
- dependents for health and miscellaneous plans
- beneficiaries for insurance, savings, stock purchase and miscellaneous plans.
(C) SAP AG HR325 3-12

Basic Settings & Common Concepts: Unit Summary
z Describe the concept of benefit

areas.
z Describe the concept of plan types.
z Define basic settings needed for your
benefits configuration.
z Describe common concepts used
throughout the benefits system.
SAP AG 1999
(C) SAP AG HR325 3-13

Health Plans
Contents:
z Health plan general data

z Options
z Dependent coverages
z Costs
z Evidence of insurability (EOI)
SAP AG 1999

Health Plans: Unit Objectives
z Set up a health plan that includes the following:

Options
Dependent coverage
Cost variants and rules
z Interpret the cost grouping feature.
z Set up EOI conditions for a health plan.
SAP AG 1999

Health Plans: Course Overview Diagram
Basic
Concepts
Flexible
Stock Spending
Purchase Accounts
Plans (North
America)

Customizing
Tools
America)
SAP AG 1999

Health Plans: Business Scenario
Your company has two new health plans that need

to be set up:
z Standard Medical with the options
Deductible and No deductible
z Standard Dental with only one option
SAP AG 1999

Health Plan Setup
Category HEALTH
HEALTH
Plan Type MEDICAL

MEDICAL DENTAL
DENTAL
...
Plan STANDARD
STANDARD MEDICAL
MEDICAL HMO
HMO
Option NODT
NODT YSDT
YSDT HMO
HMO
Dependent
EE
EE EEF
EEF EE
EE EEF
EEF EE
EE EE1
EE1 EEF
EEF
Coverage
Cost
CST1
CST1 CST3
CST3 CST2
CST2 CST4
CST4 CST1
CST1 CST3
CST3 CST5
CST5
Variant
SAP AG 1999
Health plans can be set up in different ways. Above, you can see possible ways to set up a health plan.
The plan category Health is pre-defined by SAP. The plan type is defined in the Basic Settings part of
the Benefits IMG.
The plan, option, dependent coverage and cost variant building blocks are all set up in the Health Plans
section in the Benefits IMG.
Options represent the different levels of health care within a health plan.
An option may consist of varying levels of dependent coverage.
Each combination of option and dependent coverage has a cost variant.
Tip:
At the option level, you can set up a waive option with zero costs to positively record that an employee
has not elected the benefit plan. For example, if an employee is covered under a spousal plan.

Define Health Plan General Data
Change View Benefit Health Plan General Data: Details
Start End
STMD 01.01.1900 31.12.9999

Benefit plan Standard Medical
General data
Plan type MEDI Medical Plan number 1236658734
Plan status OP Open Short text SMedical

Provider 00000001 Prudential Assign
Assign dependent/
dependent/
beneficiary
beneficiary group
group
Health plan attributes
Dependent relevant Selection groups
Pre-tax allowed Credits allowed

Post-tax allowed ER costs are not credited to employee Set
Set up
up dependent/
dependent/
Insurance code HLT
beneficiary
beneficiary group
group
feature
feature (RLPGR)
(RLPGR)
SAP AG 1999
Here, you define the name and the characteristics of the health plan. If dependents are relevant and you
wish to restrict the number of possible dependents you defined in the IMG step Define dependents and
beneficiaries, you can do so by selecting Selection groups and assigning a dependent/beneficiary group
to the plan. For this group, you then have to set up the RLPGR feature to dynamically sort family/related
persons (infotype 0021) into the correct group at enrollment. This has been explained in detail in the
Basic Settings & Common Concepts unit.
You can define if the plan costs are pre-tax or post-tax. If you select both indicators, the employee can
choose on the enrollment screen whether the deductions should come from pre-tax or post-tax salary.
You can define if employees are allowed to use the credit from their credit plans to pay for the costs of
this plan.
The insurance code identifies what type of Health Insurance plan it is. These codes are required for the
IDOC data transfer and are defined by the ASC X12N 834 Standard and not by SAP. This code is only
needed if you use the IDOC data transfer to the provider.
The employer portion of costs for a benefit plan can take either of the following forms:
- Separate cost (indicator ER costs are not credited to employee set): The employer portion is not
credited to the employee. The employer cost is an additional cost and the employee's pay check is not
affected.
- Credit to the employee (indicator ER costs are not credited to employee not set): The employer portion
is used to reduce the employees cost for the plan.

Health Plan Options and Dependent Coverage
Change View Benefit Health Plan Option: Overview

Options...
Options...
STMD Standard Medical
Benefit plan
Benefit Health Plan Option
Text
are
are defined
defined for
for
No deductible each
each health
health plan
plan
Yes deductible individually.
individually.
Change View Benefit Dependent Coverage: Overview

Dependent
Dependent
coverage...
coverage... Dependent coverage Description Maximum dependents
EE Employee only
EE + 1 Employee + Spouse 1 is
is valid
valid for
for
EE + F Employee + Family 20
all
all health
health plans.
plans.
SAP AG 1999
Options are defined for each health plan. Options represent the coverage choices an employee can make
within a health plan.
Dependent coverage are defined for all health plans.
Options and dependent coverage are elements used later when you assign the attributes of a health plan
(IMG step Assign health plan attributes).

Formula and calculation rules
Cost formula Calculation rule
Credit formula Calculation rule
Coverage
formula Calculation rule
Employee
contribution rule Rule criteria
Employer
contribution rule Rule criteria
SAP AG
In benefits customizing, the above five plan attributes are set up according to a pattern that is common to
all. This pattern is as follows;
One formula or rule defines which factors (e.g. age, salary) will influence the calculation.
The formula or rule points to several calculation rules or rule criteria. Within these, the actual amounts
are defined, for each combination of factors stated within the formula or rule.
The formula or rule not only defines which factors affect the calculation, but it also defines how the
actual groups of employees are broken down. The salary, age and length of service groups are defined
within a criteria ID. This is defined before the formula or rule, which simply references it.
Each of the above formulas and rules can use its own feature to further create employee groups. (See the
course appendix for a list of benefits features.)
The cost formula has the additional possible factors of gender and smoker, to enable you to differentiate
between employees.
Each of the formulas and rules will be covered in more detail at the relevant points during the course.

Cost Variant, Grouping and Rule
Parameter
Parameter group
group
Cost
Cost
variant
variant
Gender,
Gender, Cost
Cost Salary
Salary Age
Age Seniority
Seniority
Smoker
Smoker grouping
grouping group group group
group group group
(CSTV1)
(CSTV1)
Cost
Cost rule
rule
SAP AG 1999
The cost variant defines what determines the cost of a health plan. It may use a parameter group, as
described above, and in addition:
- gender
- smoker/non-smoker
- cost grouping (feature CSTV1 for further differentiation between employees, based on other
employee criteria, such as geographical location, job classification, marital status etc.)
The parameter group allows you to group employees according to salary, age and seniority for cost
calculation.
Age, gender and smoker criteria can alternatively be taken from the spouse.
The cost rule then defines the actual cost of the plan for an employee who may have any combination of
the above criteria. For each combination, you must define a cost rule.

Cost formula
STANDARD
STANDARD NODT
NODT EEF
EEF
MEDICAL
MEDICAL
CST3
CST3
Criteria
Criteria ID
ID Gender
Gender Smoker
Smoker Cost
Cost group
group
Salary
Salary groups
groups LOS
LOS group
group Age
Age groups
groups
R
SAP AG
You can set up any combination of these criteria.

Each adds an extra dimension to the cost formula.
For every variation you must define a cost formula calculation rule.
(C) SAP AG HR325 4-10

Cost Grouping Feature - CSTV1
Employee
Benefit cost grouping

Cost grouping Description
FAR Far
HRLY Hourly paid
NEAR Near
SLRY Salaried
Benefit
Benefit
area
area
Benefit
Benefit Benefit
Benefit
plan
plan plan
plan
Employee Employee Employee

Zip code
group group group
NEAR
NEAR FAR
FAR HRLY SLRY
HRLY SLRY TEMP
TEMP Union
Union A
A Union
Union B
B
SAP AG 1999
The cost grouping allows you to include other cost criteria, which are not included in the cost variant.
The cost grouping feature's technical name is CSTV1.
The cost grouping feature, as all other features, processes the data of an employee and allocates him or
her to the correct cost grouping.
(C) SAP AG HR325 4-11

Define Cost Grouping & Set up Feature
Change View Benefit Cost Grouping
Cost grouping Description
FAR Far
HRLY Hourly Feature
NEAR Near
SLRY Salaried Process feature CSTV1: decision tree
CSTV1 CSTV1 Cost grouping
BAREA Benefit area
BPLAN Benefit Plan

After defining a
cost grouping, CAR
you must set up the CSTV1 PSTLZ ? 20000 Zip code compared with 20000
feature accordingly. < (smaller)

NEAR
otherwise
FAR
STMD
PERSK Employee subgroup

X1 Hourly rate/wage
HRLY
X0 Salaried employee
SLRY
SAP AG 1999
This is an example of how a feature can actually be set up in the system.

In this example, the feature is making decisions on benefit area (BAREA), benefit plan (BPLAN), zip
code (PSTLZ), and employee subgroup (PERSK).
The cost groupings being assigned here are NEAR, FAR, HRLY and SLRY.
You define the cost groupings and set up the feature under Define employee groupings Define cost
groupings in the Benefits IMG.
(C) SAP AG HR325 4-12

Define Cost Variant
Change View Benefit Cost Variant Health Plan: Details
Benefit plan STMD Standard Medical
Cost variant SCOS Standard Cost Variant
Cost criteria
Period Monthly
Parameter group PG1 Parameter group 1
Salary Age Seniority IfIf you

you choose
choose oneone oror
Feature
Feature CSTV1
CSTV1 Cost grouping Gender Smoker more
more of of these
these criteria,
criteria,
you
you have
have toto specify
specify
Determination of age, gender, smoker relevancy
aa parameter
parameter group.
group.
Relevant data from Employee The
The parameter
parameter group
group
Spouse contains
contains thethe relevant
relevant
Salary basis Age basis salary,
salary, age
age and
and
Cutoff day .
seniority
seniority groups
groups youyou
Cutoff day .
previously defined.
previously defined.
Seniority basis
Cutoff day . Hire date override

Leaving date override
Calc. process
SAP AG 1999
The cost variant defines the factors that influence the cost of the plan. Once you have defined the
parameter group and the cost groupings (and set up feature CSTV1), you set up the cost variant itself, as
shown above.
Here, you define the period on which the costs defined later in the cost rules are based.
Example:
y Cost varies according to an employee's seniority, and whether the employee is hourly paid, salaried, in
union A, or in union B.
y The parameter group supplies the groups for seniority. The cost grouping supplies the groupings for
hourly paid/salaried/union A/union B.
You can choose whether the data for the determination of age, gender and smoker should be taken from
the employee or the spouse.
Note that, if the cost is to be based on the employees salary, the system uses the employees benefit
salary for the calculation.
The cutoff date and date override concept has been explained in detail in the Basic Settings & Common
Concepts unit.
The calculation process you can enter here, is used within the HR_Seniority function module (SAP
Standard Seniority Calculation) for the calculation of an employment period. If you leave this field
empty, a default calculation process will be used.
(C) SAP AG HR325 4-13

Cost Rules
Cost
Cost Grouping
Grouping
Salaried
Salaried Hourly
Union
Union A
A Union
Union B
B Staff
Staff Staff
00 -- 22
years
years
Group
Seniority Group
33 -- 55
years
years
Seniority
66 -- 10
10
years
years
10>
10>
years
years
SAP AG 1999
You must define a cost rule for every possible combination of cost criteria defined within the cost
variant. If you have not defined any criteria in the cost variant, you have to define exactly one rule for
this variant.
The employee's personal data places him or her in exactly one of the cost rules.
Example:
y Each box in the diagram represents a cost rule.
y The dark box represents a cost rule applicable to employees:
- in cost grouping Salaried'
- with a seniority of 3-5 years
Note:
When setting up the seniority groups for a certain parameter group in the IMG (Benefits Administration
> Basic Settings > Define employee groupings > Define employee criteria groups > Define seniority
groups), please note that the seniority has to be entered as months.
(C) SAP AG HR325 4-14

Assign Health Plan Attributes
Plan Option Dependent Cost

Coverage Variant
EE NDE1
NODT EE+1 NDE1

STANDARD EE+F NDEF
MEDICAL
YSDT ...
Change View Benefit Health Plan: Overview
After you have defined
the options, dependent Benefit plan
coverage and cost variants
Benefit Health Plan
for your health plan, you
Option Text Dependent cov. CostVa Text Start date End date
must assign those attributes
at this point. NODT No deductible EE NDEE No deduct. EE only 01.01.1900 31.12.9999
NODT No deductible EE + 1 NDE1 No deduct. EE + 1 01.01.1900 31.12.9999
NODT No deductible EE + F NDEF No deduct. EE + F 01.01.1900 31.12.9999
YSDT Yes deductible EE DEE Deductible EE only 01.01.1900 31.12.9999
YSDT Yes deductible EE + 1 DEE1 Deductible EE + 1 01.01.1900 31.12.9999
YSDT Yes deductible EE + F DEEF Deductible EE + F 01.01.1900 31.12.9999
SAP AG 1999
This is the final step in defining a health plan.

All the building blocks (options, cost variant etc.) you have already defined, are brought together here.
(C) SAP AG HR325 4-15

Evidence of Insurability (EOI) - Health
Option 2 Dependent Only on initial

coverage enrollment
Option 1
Always
Health plan
Action when
EOI not Active
provided Pending
Grace period
SAP AG
EOI set up allows you to mark certain plans as requiring evidence of insurability to participate in the
plan. This can be narrowed down to merely one option or dependent coverage.
How the system enrolls the employee at enrollment is specified.
The grace period to provide EOI is defined.
(C) SAP AG HR325 4-16

Define Evidence of Insurability Conditions
Change View Benefit Evidence of Insurability Health Plan
Start End
STMD Standard Medical 01.01.1900 31.12.9999

Benefit plan
Selection of options requiring evidence of insurability
Initial enrollment/ enrollment any time Options requiring EOI

Change of coverage Changes requiring EOI
Action Create pending record for desired option

Grace period 1 Months From enrollment date
From participation date
Benefit Evidence of Insurability: Option Jump Assignment Benefit Evidence of Insurability Option Assignment
StOpt. Start option text StDcv. TgtOpt Target option text TgDcv. Option Text Dep. Description InitEnrol.
YSDT Yes deductible EE NODT No deductible EE NODT No deductible EE + 1 Employee + Spouse
NODT No deductible EE + F Employee + Family
YSDT Yes deductible EE + F Employee + Family
SAP AG 1999
You can configure the system to enroll the employee in the plan in either pending or active status, while
awaiting EOI.
You can define grace periods for the provision of EOI.
Under Options requiring EOI, you enter options and dependent coverage for initial or anytime
enrollments for which EOI is required.
Under Changes requiring EOI, you enter start options and start dependent coverage as well as target
options and target dependent coverage for option jumps requiring EOI.
In the EOI Monitor, you can trace whether employees have provided required EOIs or not.
(C) SAP AG HR325 4-17

Evidence of Insurability on Infotype 0167 (Health)
Change Health Plans
Personnel no
4401
Name Rose Salizar
... 03.08.1999
From to 31.12.1999 Chng 03.08.1999
Plan STMD Standard Medical
This
This symbol
symbol shows
shows
Administration Plan data Costs Dependents Additional data
that
that thethe infotype
infotype
Participation data record
record is is pending
pending
Eligible on 01.07.1999 (locked).
(locked).
Eligibility override IfIf no
no symbol
symbol appears,
appears,
Participation date 03.08.1999 the
the record
record is
is active
active
Type of enrollment Using open enrollment (unlocked).
(unlocked).
Evidence of insurability
Statement required End of grace period 17.09.1999
Insurability proven
EOI
EOI information
information on
on the
the
Health
Health Plans infotype (0167)
Plans infotype (0167)
SAP AG 1999
The active or pending infotype records are created during enrollment. Whether the plan requires EOI and
whether the employee has provided EOI is stored on the Health Plans infotype (0167) record.
Additionally, the grace period is shown here.
See the Benefits Processing unit for further information on EOI processing.
For the administration of active and pending record status, the lock mechanism of the Personnel
Administration Infotype concept is used. For a locked record (pending), the lock symbol appears on the
infotype screen. For an unlocked (active) record, no symbol is shown.
(C) SAP AG HR325 4-18

Health Plans: Unit Summary

z Set up a health plan that includes
the following:
Options
Dependent coverage
z Interpret the cost grouping feature.
z Set up EOI conditions for a health
plan.
SAP AG 1999
(C) SAP AG HR325 4-19

Insurance Plans
Contents:
z Insurance plan general data
z Coverage
z Cost
z Combined coverage limits
SAP AG 1999

Insurance Plans: Unit Objectives
z Set up an insurance plan that includes

the following:
Coverage variants and rules
Combined coverage limits
z Interpret the cost grouping and coverage

grouping features.
z Set up EOI conditions for an
insurance plan.
SAP AG 1999

Insurance Plans: Course Overview Diagram
Basic
Concepts
Flexible
Stock Spending
Purchase Accounts
Plans (North
America)

Customizing
Tools
America)
SAP AG 1999

Insurance Plans: Business Scenario
z Your company needs to set up two new

insurance plans:
Basic Life with two levels of coverage
Additional Life with only one coverage option
z There is a combined coverage limit for the

two insurance plans.
SAP AG 1999

Insurance Set-Up
Category INSURANCE
Plan Type LIFE DLIF
Plan Std Life
Option Option 1 Option 2
Coverage
Basic 1 Basic 2
Formula
Cost
O1 Cost O2 Cost
Formula R
SAP AG
Insurance plans can be set up in different ways. Above you can see one possible way to set up an
insurance plan.
The category Insurance' is pre-defined by SAP. Plan type is defined in the Basic Settings in the benefits
IMG.
The Plan, Options, Coverage formula and Cost formula building blocks are all set up in the Insurance
plans section of the IMG.

Insurance Plan Set Up - Detail
Basic Life
Plan
Option Option 1 Option 2
Coverage
Basic 1 Basic 2
Variant
Coverage
25K 1X 50k 2X
Rule
Cost O1 Cost O2 Cost

Variant
Cost Rule 2 per mo 1 per mo 0.5 per mo 1.5 per mo
SAP AG 1999
This is the same set up as the previous slide, but in more detail and from the plan level downwards.

Define Insurance Plan General Data
Change View Benefit Insurance Plan General Data: Details
Start End
LIFE Basic Life 01.01.1900 31.12.9999

Benefit plan
General data
Plan type LIFE Life Insurance Plan number 12456456546
Plan status OP Open Short text BasicLife

Provider 00000007 Provider 7
Assign
Assign dependent/
dependent/
beneficiary
beneficiary group
group
Insurance plan attributes
Benefic. relevant Selection groups
EE beneficiary Pre-tax allowed Credits allowed
Contingency benefic. Post-tax allowed Imputed income

Set
Set up
up dependent/
dependent/
Group Term Life ER costs are not credited to employee
beneficiary
beneficiary group
group
feature (RLPGR)
feature (RLPGR)
SAP AG 1999
Here, you define the name and the characteristics of the insurance plan.
The concept of the dependent/beneficiary group has already been explained in detail in the Health Plans
unit.
You can specify whether the actual employee can be specified as a beneficiary and whether it is possible
to store contingency beneficiaries.
You can define if the plan costs are pre-tax or post-tax. If you select both indicators, the employee can
choose on the enrollment screen whether the deductions should come from pre-tax or post-tax salary.
You can define if employees are allowed to use the credit from their credit plans to pay for the costs of
this plan.
The employer portion of costs for a benefit plan can take either of the following forms:
y Separate cost (indicator ER costs are not credited to employee set): The employer portion is not
credited to the employee. The employer cost is an additional cost and the employee's pay check is not
affected.
y Credit to the employee (indicator ER costs are not credited to employee not set): The employer
portion is used to reduce the employees cost for the plan.
The Group Term Life and Imputed Income fields are US-specific.

Coverage Variant, Grouping and Rule
Parameter
Parameter group
group
Coverage
Coverage
variant
variant
Coverage
Coverage Salary
Salary Age
Age Seniority
Seniority
grouping
grouping group
group group
group group
group
(COVGR)
(COVGR)
Coverage
Coverage rule
rule
SAP AG 1999
The coverage variant defines what factors influence the coverage an employee is entitled to in an
insurance plan. It may use a parameter group, as described above, and in addition coverage groupings
(feature COVGR for further differentiation between employees, based on other employee criteria, such
as geographical location, job classification, marital status etc.).
The parameter group allows you to group employees according to salary, age and seniority.
There are two stages to deciding how to set up your coverage variants. Firstly, you must know how
coverage varies according to plan and option in this plan category. Secondly, you must know how the
option's coverage varies according to employee data. The first stage determines how many coverage
variants you need, the second how each coverage variant is set up.
The coverage rule then defines the actual coverage of the plan for an employee who may have any
combination of the above criteria. For each combination, you must define a coverage rule.

Coverage Grouping Feature - COVGR
Employee
Benefit coverage grouping
Coverage grouping Cover.grouping text
COG1 Coverage grouping 1
COG2 Coverage grouping 2
Benefit
Benefit
area
area
Benefit
Benefit Benefit
Benefit
plan
plan plan
plan

Employee
Zip
Zip code
code group
group group
group
NEAR
NEAR FAR
FAR COG1 COG2
COG1 COG2 TEMP
TEMP Union
Union A
A Union
Union B
B
SAP AG 1999
The coverage grouping allows you to include other cost criteria, which are not included in the coverage
variant.
The coverage grouping feature's technical name is COVGR.
The coverage grouping feature, as all other features, processes the data of an employee and allocates
him or her to the correct coverage grouping.

Insurance Plans
Contents:
z Insurance plan general data
z Coverage
z Cost
z Combined coverage limits
SAP AG 1999
(C) SAP AG HR325 5-10

Coverage Rules
Coverage
Coverage Grouping
Grouping
Union
Union A
A Union
Union B
B COG1
COG1 COG2
COG2
00 -- 22
years
years
Group
Seniority Group
33 -- 55
years
years
Seniority
66 -- 10
10
years
years
10>
10>
years
years
SAP AG 1999
You must define a coverage rule for every possibility within the coverage variant. If you have not
defined any criteria in the coverage variant, you have to define exactly one rule for this variant.
The employee's personal data places him or her in one of the coverage rules.
Example:
y Each box in the diagram represents a coverage rule.
y The dark box represents a coverage rule applicable to employees:
- in coverage grouping COG1'
Note:
(C) SAP AG HR325 5-11

Define Coverage Rule
Change View Benefit Coverage Rule Insurance Plan: Details
Benefit plan LIFE Basic Life Start End
BASC Basic Coverage 01.01.1900 31.12.9999

Cover. variant
Salary group
The
The system
system only
only
Age group
allows
allows you
you toto
make
make entries
the
entries for
the criteria
criteria that
for
that
Seniority group
Cover. grouping
{ 5
COG1
3-5 years
Coverage grouping 1
you
you have
have already
already Base amount Minimum total amount
defined as
defined as Coverage amount 130,000.00 UNI Minimum total amount 200,000.00 UNI
relevant
relevant in
in the
the Salary factor 2.00000 Min. factor 3,0000
coverage
coverage variant.
variant. Rounding rule Rounding rule
Rounding div. Rounding div.
Larger amount Smaller amount
Additional insurance coverage Maximum total amount
Additional unit 1,000.00 UNI Maximum total amount 500,000.00 UNI

Minimum units Max.sal.factor
Maximum units 100 Rounding rule
Rounding div.
Larger amount Smaller amount
SAP AG 1999
This is where the actual coverage is defined. For each possible combination of criteria that you have
already defined in the coverage variant, you have to define a coverage rule.
Coverage can be a factor of salary, a flat amount or a combination of the two.
The coverage limits within the plan are defined here.
Example (employee earns 35,000 UNI annually and has chosen 8 additional units):
y BASIS = 130,000 UNI + (2 x 35,000 UNI) = 200,000 UNI
y ADDITIONAL= 8 x 1000 UNI = 8,000 UNI
y TOTAL = 208,000 UNI
y MINIMUM LIMIT = LARGER OF (200,000 UNI, 105,000 UNI) = 200,000 UNI

y MAXIMUM LIMIT = 500,000 UNI
y COVERAGE 208,000 UNI is within limits.
(C) SAP AG HR325 5-12

Cost formula
Criteria
Criteria ID
ID
Cost
Cost
formula
formula
Length
Length
Gender
Gender Cost
Cost Salary
Salary Age
Age of
of
Smoker
Smoker group group group Service
group group group Service
group
group
Cost
Cost formula
formula calculation
calculation rule
rule
SAP AG
Cost may be graduated according to one or a combination of the following:

y Salary
y Age
y Length of service (LOS)
The criteria ID allows you to group employees according to these criteria for cost calculation.
The cost formula defines what determines the cost of a health plan. It may use a criteria ID, as described
above, and in addition:
y gender
y smoker/non-smoker
y cost group
The cost formula calculation rule then defines the cost of the plan for an employee who may have any
combination of the above criteria.
(C) SAP AG HR325 5-13

Cost formula
Standard
Standard Option
Option 11 01
01 Cost
Cost
Life
Life
Criteria
Criteria ID
ID Gender
Gender Smoker
Smoker Cost
Cost group
group
Salary
Salary groups
groups LOS
LOS group
group Age
Age groups
groups
SAP AG
You can set up any combination of these criteria.

Each adds an extra dimension to the cost formula.
For every variation you must define a cost formula calculation rule.
(C) SAP AG HR325 5-14

Cost group feature Employee
Benefit cost group

Cost. Text
HRLY Hourly paid
SLRY Salaried
Benefit
Benefit
area
area
Benefit
Benefit Benefit
Benefit
plan
plan plan
plan

Zip code
group group group
AREA1 AREA2 HRLY SLRY

HRLY SLRY TEMP Union
Union A
R
AREA1 AREA2 TEMP A Union

Union B
B
SAP AG
The cost group feature's technical name is CSTV1.

The cost group feature, as all other features, processes the data of each employee, one at a time and
allocates him or her to the correct cost group.
The cost group allows you to include other cost criteria, which are not included in the cost formula.
(C) SAP AG HR325 5-15

Cost group feature
Variable key C D Operations

000010 D BAREA
000020 ** D BPLAN
000030 ** CAR D PSTLZ?20000
000040 ** CAR < &CSTV1=NEAR,
000050 ** CAR * &CSTV1=FAR,
000060 ** STMD D PERSK
000070 ** STMD U1 &CSTV1=HRLY,
000080 ** STMD U4 &CSTV1=SLRY,
000090 ** DENT D PERSK
000100 ** DENT U1 &CSTV1=HRLY,
000110 ** DENT U4 &CSTV1=SLRY,
000110 ** STLF D PERSK
000120 ** STLF U1 &CSTV1=HRLY,
000130 ** STLF U4 &CSTV1=SLRY,
R
SAP AG
This is how a feature is actually set up in the system.

In this example, the feature is making decisions on benefit area (BAREA), benefit plan (BPLAN), zip
code (PSTLZ), and employee subgroup (PERSK).
The groups being assigned here are NEAR, FAR, HRLY and SLRY.
This is the CSTV1 feature.
(C) SAP AG HR325 5-16

Define Cost Variant
Change View Benefit Cost Variant Insurance Plan: Details
Benefit plan LIFE Basic Life
COST Cost for Life Insurance

Here,
Here, you
you indicate
indicate
Cost variant
whether
whether you you want
want
to
to define
define different
different
Cost criteria
Period Monthly Step-rate cost
cost calculation
calculation
Parameter group PG1 Parameter group 1 for
for different
different
Salary Age Seniority levels
levels ofof coverage.
coverage.
Cost grouping Gender Smoker
Determination of age, gender, smoker relevancy
Relevant data from

Feature
Feature CSTV1
CSTV1 IfIf you
you choose
choose one
one or
or
Employee
Spouse
more of these
more of these
criteria,
criteria,
Salary basis Age basis
you
you have
have toto specify
specify
Cutoff day . Cutoff day . aa parameter
parameter group.
group.
The
The parameter
parameter group
group
Seniority basis
contains
contains thethe relevant
relevant
Cutoff day . Hire date override
salary,
salary, age
age and
and
Leaving date override
Calc. process
seniority
seniority groups.
groups.
SAP AG 1999
The concept of cost variant, rule and grouping (feature CSTV1) was already explained in detail in the
Health Plans unit.
In the example shown above, the costs for the insurance plan depend on an employees age, seniority
and cost grouping. For each possible combination of these criteria, you later have to define a cost rule
with the actual costs.
Note that, if the cost is to be based on the employees salary, the system uses the employees benefit
salary for the calculation.
You can choose whether the data for the determination of age, gender and smoker should be taken from
the employee or the spouse.
In the step-rate field, you specify if your plan includes step limits. Step limits are explained at a later
point in this unit. For each step limit, you later have to define a cost rule.
The cutoff day concept has been explained in detail in the Basic Settings & Common Concepts unit.
(C) SAP AG HR325 5-17

Cost Rules
0-3
years
Seniority
Seniority group
group 3-6
years
>6 Cost
Cost rules
rules
years
HRLY
Cost
Cost grouping
grouping SLRY
<25 25
Age
Age groups
groups
SAP AG 1999
You must define a cost rule for every possible combination of cost criteria defined within the cost
variant. If you have not defined any criteria in the cost variant, you have to define exactly one rule for
this variant.
The employee's personal data places him or her in exactly one cost rules.
Example:
y Each box in the diagram represents a cost rule.
y The dark box represents a cost rule applicable to employees:
- of an age greater than 25 years
Note:
(C) SAP AG HR325 5-18

Define Cost Rule
Change View Benefit Cost Rule Insurance Plan: Details
Benefit plan LIFE Basic Life Start End
COST Cost for Life Insurance 01.01.1900 31.12.9999

Cost rule variant
Salary group
{
Depending
Depending on on Age group
>25 25 years and older
the
the cost
cost criteria
criteria Seniority group >6 6 years and longer
you
you have
have
Cost grouping HRLY Hourly paid
chosen
chosen in in the
the
cost Female Male
cost variant
variant
view,
view, the
the Smoker
relevant
relevant fields
fields Step limit 0
Provider costs
are
are ready
ready forfor
Basis for cost rule Costs UNI
input
input in
in this
this
Cost period Monthly 0.12
view.
view. Cost factor
Base unit 1,000.00 UNI Rounding rule
Rounding div.
Employee costs Employer credit

Amount UNI Amount UNI
Cost factor 0.12 Credit factor 0.10
Rounding rule Rounding rule
Rounding div. Rounding div.
SAP AG 1999
Cost can be flat costs or based upon the coverage of the insurance plan. In the case of flat costs, you
need to enter amounts here. If cost is based on coverage, you need to specify the cost factor per base
unit. The two examples below show how cost is graduated, based on how much coverage the employee
has chosen.
Example 1:
y An employee has 150,000 UNI COVERAGE
y COST is 0.12 UNI per 1000 UNI
y COST for this employee in this plan is (150,000/1000) x 0.12 = 18.00 UNI
Example 2:
y An employee has 175,000 UNI COVERAGE
y COST is 0.6 UNI per 5,000 UNI
y COST for this employee in this plan is (175,000/5,000) x 0.6 = 21.00 UNI
The step limit is the maximum amount of coverage to which the cost rule will be applied.
As soon as the coverage exceeds this amount, the next cost rule with a higher step limit is used to
calculate cost. The costs for the individual step limits are then added together to form the total cost.
(C) SAP AG HR325 5-19

Step Limits
Plan
Plan coverage
coverage
100,000 Cost 0.23 per 1,000
80,000
Cost 0.19 per 1,000
40,000
Cost 0.14 per 1,000
SAP AG 1999
Step limits are levels which differentiate cost of coverage within an employee's insurance coverage.
They allow you to graduate cost, according to how much coverage the employee has chosen. For
example, the first 40,000 UNI of coverage may be a standard cost, then any subsequent coverage over
this amount is more expensive.
You must enter the various step limits when you define the cost rules.
Example:
y From a possible 100,000 UNI, an employee has chosen 85,000 UNI COVERAGE
y COST is then
y up to 40,000 UNI -> 40,000 (0.14/1000) = 5.60 UNI
y up to 80,000 UNI -> 40,000 (0.19/1000) = 7.60 UNI
y Rest -> 5,000 (0.23/1000) = 1.15 UNI
y TOTAL COST -> = 14.35 UNI
(C) SAP AG HR325 5-20

Assign Insurance Plan Attributes
Define insurance plan option Assign cost variant and coverage variant
Change View Benefit Insurance Plan: Details
Start End
LIFE 01.01.1900 31.12.9999

Benefit plan Basic Life
CovOption LEV1 Coverage Level 1
Assigned rule variants
Cost variant COST Cost for Life Insurance
Cover. variant BASC Basic Coverage
SAP AG 1999
This is the final step in defining an insurance plan.

All the building blocks (coverage variants etc.) you have already defined, are brought together here and
the options (levels of coverage) for the insurance plan are defined.
You allocate a cost variant and coverage variant to every option of the insurance plan.
Remember that the cost variant defines the employee data that affect cost, and the coverage variant
defines the employee date that affects coverage. These variants point to the relevant calculation rule, for
each employee.
Example:
y The Standard Life insurance plan has the following two options:
- 40,000 UNI
- 70,000 UNI
y The cost is directly proportional to the coverage the employee chooses. The coverage variants and cost
variant have already been defined. The two options are defined as follows:
Option Coverage variant Cost variant
40K 40K STLI

70K 70K STLI
(C) SAP AG HR325 5-21

Evidence of Insurability (EOI) - Insurance
Max coverage.
allowed: Defined as:
- Initial enroll. - amount

- change cov. - factor of
- any time salary
Insurance
plan
Active
Action when Pending
EOI not
provided Active max. jump
Pending + active max jump
Grace period
SAP AG 1999
EOI set up allows you to mark certain plans as requiring evidence of insurability to participate in the
plan. This can be specified as a particular coverage level within a plan.
Additionally, how the system enrolls the employee at enrollment is specified.
(C) SAP AG HR325 5-22

Define Evidence of Insurability Conditions
Change View Benefit Evidence of Insurability Insurance Plan: Details
Start End
ALIF 01.01.1900 31.12.9999

Benefit plan Additional Life
Maximum coverage without evidence of insurability
Amount Factor
Initial enrollment 0.01 UNI x Salary
Change of coverage 24,999.00 UNI x Salary
Enrollment any time 100,000.00 UNI x Salary
Salary factor Salary basis
Rounding rule
Cutoff day .
Rounding div.
Action Create active record for desired option

Grace period 1 Months From enrollment date
Possible
Possible actions:
actions:
From participation date
Create active record for desired option

Createpending
Create pendingrecord
recordfor
fordesired
desiredoption
option
Createactive
Create activerecord
recordfor
forbiggest
biggestjump
jumppossible
possible
Createpending
Create pendingrecord
recorddesired
desiredoption,
option,active
activerecord
recordmaximum
maximum
coveragejump
coverage jump
SAP AG 1999
You can specify maximum coverage without EOI when the employee enrolls in the plan for the first
time, when he or she elects a change of coverage, or for enrollment at any time.
You can configure the system to store employees' elections in either pending or active status, while
awaiting EOI. You can also create an active record for biggest option possible not requiring EOI or both
an active record for biggest option possible and a pending record for the desired option requiring EOI.
You can define grace periods for the provision of EOI.
(C) SAP AG HR325 5-23

Evidence of Insurability on Infotype 0168
Display Insurance Plans
Personnel no
4401
Name Rose Salizar
... 03.08.1999
From to 31.12.1999 Chng 03.08.1999
Plan ALIF Additional Life
Administration Plan data Ins.cover. Costs Beneficiaries
Participation data
01.07.1999
Eligible on No
No symbol
symbol appears
appears here;
here;
Eligibility override that
that means that this record
means that this record
03.08.1999
Participation date is
is active
active (unlocked).
(unlocked).
Type of enrollment Default IfIf aa lock
lock symbol
symbol isis shown,
shown,
the
the infotype
infotype record
record
Evidence of insurability is
is pending
pending (locked).
(locked).
Statement required End of grace period
Insurability proven
EOI
EOI information
information on
on the
the
Insurance
Insurance Plans
Plans infotype
infotype (0168)
(0168)
SAP AG 1999
The active or pending infotype records are created during enrollment. Whether the plan requires EOI and
whether the employee has provided EOI is stored on the Insurance Plans infotype (0168) record.
Additionally, the grace period is shown here.
See the Benefits Processing unit for further information on EOI processing.
For the administration of active and pending record status, the lock mechanism of the Personnel
Administration Infotype concept is used. For a locked record (pending), the lock symbol appears on the
infotype screen. For an unlocked (active) record, no symbol is shown.
(C) SAP AG HR325 5-24

Combined Coverage Limits
z Combined coverage limits for more than

one plan
z Define mathematical equations in two IMG

steps:
Define combined coverage limits

Define combined coverage limit
expressions
SAP AG 1999
In the coverage variant, you set up coverage limits for the plan itself.
Under combined limits, you set up coverage limits that span more than one plan.
(C) SAP AG HR325 5-25

Combined Coverage for Insurance I
z Example 1:
Basic Life + Additional Life cannot exceed 200,000 UNI
Limit Expression
200,000 >= Basic Life 1.0
Additional Life 1.0
SAP AG 1999
The solved equation must have the monetary limit on one side and the plan expressions on the other.
The limit and the limit expression are set up in 2 separate views in the IMG.
Example:
200,000 UNI is the maximum coverage an employee can have under Basic Life and Additional Life.
y 200,000 UNI >= (1.0 x LIFE) + (1.0 x ALIF)
See the Benefits IMG for further information. Search for Combined coverage'.
(C) SAP AG HR325 5-26

Combined Coverage for Insurance II
z Example 2:
Additional Life cannot exceed 50% of Basic Life
Limit Expression
0 <= Basic Life .5
Additional Life -1.0
SAP AG 1999
Example:
y Additional Life (ALIF) cannot exceed 50% of Basic Life (LIFE)
y ALIF <= 0.5 x LIFE
y 0 <= (0.5 x LIFE) - (1.0 x ALIF)
(C) SAP AG HR325 5-27

Insurance Plans: Unit Summary
z Set up an insurance plan that

includes the following:
Coverage variants and rules
Combined coverage limits
z Interpret the cost grouping and

coverage grouping features
z Set up EOI conditions for an
insurance plan
SAP AG 1999
(C) SAP AG HR325 5-28

Savings Plans
Contents:
z Savings plan general data

z Employee and employer contributions
z Vesting
z Investments
z Combined contribution limits
SAP AG 1999

Savings Plans: Unit Objectives
z Set up a savings plan that includes the following:

Employee pre- and post-tax contributions
Employer contributions
Vesting rules and vested portions
Investment options
Combined contribution limits
z Interpret the employee and employer
contribution grouping features
SAP AG 1999

Savings Plans: Course Overview Diagram
Basic Settings
Benefits Health Insurance Savings
and Common
Overview Plans Plans Plans
Concepts
Stock
Credit Miscellaneous Flexible Benefits
Purchase
Plans Plans Administration Processing
Plans
Reporting &
Payroll
Customizing
Integration
Tools
SAP AG 1999

Savings Plans: Business Scenario
z Your company is introducing a long-term savings

plan with a pre-tax and post-tax option, and standard
saving plan with post-tax only.
z The first plan has two investment options; a
guaranteed annuity and a balanced fund. The second
plan has one mutual fund.
z An employees combined contribution to two plans
may be no more than 10% of annual salary.
z Vesting for both plans is 20% after 1 year, 40% after 2
and 60% after 3, 80% after 4 and 100% after 5 years.
SAP AG 1999

Savings Set-Up
Category SAVINGS
Plan Type LONG SHRT
Plan 401K STSV XTRA
Investment
401K STSV XTRA
group
Employee
Pre Post Pre Post Post
contribution
Employer

contribution
Vesting rule 5 year 1 year 1 year

R
SAP AG
Savings plans can be set up in many different ways. Above you can see two possible ways to set up a
savings plan.
The category Savings' is an integral part of the system. Plan type is defined in the Basic Settings in the
IMG.
The Plan, Investment group, Employee contribution, Employer contribution and Vesting rule are all set
up in the Savings plans section of the IMG.

Savings Plans
Contents:
z Savings plan general data

z Employee and employer contributions
z Vesting
z Investments
SAP AG 1999

Savings Plan Overview - Four Components
1 2
Employee
Employee Employer
Employer
contribution
contribution contribution
contribution
variant
variant variant
variant
Savings
plan
4 3
Investment
Investment Vesting
Vesting
group
group rule
rule
SAP AG 1999
A savings plan includes up to four parts, as shown above. Depending on the savings plan your company
is offering, you might define just one or two, or up to all four parts.
The savings plan contribution may be an amount, a percentage of salary, a unit or any combination of the
three.
This may be either a pre-tax or post-tax deduction, or both.
Vesting rules can only be used if an employer contribution rule is also being used.

Employee Contribution Variant, Grouping and Rule
Parameter
Parameter group
group
Employee
Employee
contribution
contribution
variant
variant
Employee
Employee
contribution
contribution Salary
Salary Age
Age Seniority
Seniority
grouping
grouping group
group group
group group
group
(EECGR)
(EECGR)
Employee
Employee contribution
contribution rule
rule
SAP AG 1999
The employee contribution variant defines what factors influence the employee contribution an
employee is entitled to in a savings plan. It may use a parameter group, as described above, and in
addition employee contribution groupings (feature EECGR for further differentiation between
employees, based on other employee criteria, such as geographical location, job classification, marital
status etc.).
The employee contribution rule then defines the actual employee contribution of the plan for an
employee who may have any combination of the above criteria. For each combination, you must define
an employee contribution rule.

Employee Contribution Grouping Feature - EECGR
Employee
Employee contribution grouping
EE contr. grouping Text
OTHR Others
SING Singles
Benefit
Benefit
area
area
Benefit
Benefit Benefit
Benefit
plan
plan plan
plan
Family Family Employee

Employee
Zip
Zip code
code status
status group
group
AREA1
AREA1 AREA2
AREA2 SING OTHR
SING OTHR ALL
ALL Union
Union A
A Union
Union B
B
SAP AG 1999
The employee contribution grouping allows you to include other cost criteria, which are not included in
the employee contribution variant. This concept was covered in the Common concepts topic in the Basic
Settings unit.
The employee contribution grouping feature's technical name is EECGR.
The employee contribution grouping feature, as all other features, processes the data of an employee and
allocates him or her to the correct employee contribution grouping.

Define EE Contribution Grouping & Set up Feature
Change View Benefit Employee Contribution Grouping

EE contr. grouping Text
OTHR Others Feature
SING Singles
Process feature EECGR: decision tree
EECGR Employee Contribution Grouping
BAREA Benefit Area
99 Internation. Simple
BPLAN Benefit Plan

After defining an employee 401K
contribution grouping, you must
FAMST Marital status key
set up the EECGR feature.
1 Marr.
OTHR
otherwise
SING
STSV
FAMST Marital status key
1 Marr.
OTHR
otherwise
otherwise ... SING

SAP AG 1999

In this example, the feature is making decisions on benefit area (BAREA), benefit plan (BPLAN), and
marital status (FAMST).
The employee contribution groupings being assigned here are SING and OTHR.
You define the employee contribution groupings and set up the feature under Define employee groupings
Define employee contribution groupings in the Benefit IMG.
(C) SAP AG HR325 6-10

Define Employee Contribution Rule
SAP AG 1999
Here, you define the actual employee contributions for each employee contribution variant for each plan.
First, you need to consider every variation of criteria that you have already defined in the employee
contribution variant. Then, for each possible combination of these criteria within the variant, you enter
the actual employee contribution.
You can define the minimum and maximum employee contribution limits for both regular payroll and
for bonus payments as a fixed amount, a percentage of salary, a contribution unit or any combination of
the three.
NOTE:
During enrollment, you can enter a contribution of 0 (zero), so that you can specifically record that an
employee has chosen not to participate in a plan.
NOTE:
During enrollment, when the employee enters his or her contribution, the limit check is only performed
within each contribution type (i.e. amounts are only checked against the limits specified for amounts,
percentage limits are only checked against the limits specified for percentages, etc.).
Instead of limits per period, you can also define annual contribution limits.
(C) SAP AG HR325 6-11

Employer Contribution Variant, Grouping and Rule
Parameter
Parameter group
group
Employer
Employer
contribution
contribution
variant
variant Employer
Employer
Sequential contribution
Sequential contribution Salary Age Seniority
Salary Age Seniority
number
number grouping group group group
grouping group group group
(ERCGR)
(ERCGR)
Employer
Employer contribution
contribution rule
rule
SAP AG 1999
The employer contribution variant defines what factors influence the employer contribution an employee
is entitled to in a savings plan. It may use a parameter group, as described above, and in addition
employer contribution groupings (feature ERCGR for further differentiation between employees, based
on other employee criteria, such as geographical location, job classification, marital status etc.).
The employer contribution rule then defines the actual employer contribution of the plan for an
an employer contribution rule.
(C) SAP AG HR325 6-12

Employer contribution group feature
Employer contribution group Employee

Cost. Text
SING Single
OTHR Others

Benefit
Benefit
area
area
Benefit
Benefit Benefit
Benefit
plan
plan plan
plan
Family Family Employee

Employee
Zip code
status status group
group
AREA1
AREA1 AREA2 SING OTHR
AREA2 SING OTHR ALL
ALL Union
Union A
A Union
Union B
B
SAP AG 1999
The employer contribution group feature's technical name is ERCGR.

The employer contribution group feature, as all other features, processes the data of each employee, one
at a time and allocates him or her to the correct employer contribution group.
The employer contribution group allows you to include other cost criteria, which are not included in the
employer contribution rule.
(C) SAP AG HR325 6-13

Employer contribution group feature
Variable key C D Operations

000010 D BAREA
000020 ** D BPLAN
000030 ** 401K D FAMST
000040 ** 401K 1 &ERCGR=SING,
000050 ** 401K * &ERCGR=OTHR,
000060 ** STSV D FAMST
000070 ** STSV 1 &ERCGR=SING,
000080 ** STSV * &ERCGR=OTHR,
000090
000100
000110
SAP AG 1999
This is how a feature is actually set up in the system.

In this example, the feature is making decisions on benefit area, benefit plan, and marital status.
This is the ERCGR feature.
(C) SAP AG HR325 6-14

Employer contribution rule criteria
Benefit plan 401K Standard 401K from to

ER contribution ALL ALL
01.01.1900 31.12.9999
Salary group
Age group
LOS group <10
ER contr. group
Sequential no. 01
Formula basis
Period 01 Monthly
Contribution definition
Amount USD
Percentage rate 10.00 From Base salary EE contribution
Contribution limit
Amount 10,000.00 USD
Percentage rate From Base salary EE contribution
SAP AG 1999
Contributions and limits are valid for the specified period (e.g. monthly).
The employer contribution consists of one of the following:
- amount
- percentage of salary
- percentage of employee contribution
The employer contribution limit consists of one of the following;
- amount
- percentage of salary
- percentage of employee contribution
(C) SAP AG HR325 6-15

Employer matching
3,500 3,500 3,500

Employee
contribution
3000
Employer
match
2000
1,750
Employer
1,000 match limit
1000 875
500
Contribution 350
250
Contribution 01 + 02 + 03
01 02 03
rules
SAP AG 1999
You can apply several employer matching rules at once to one employee contribution.To do this you use
the sequential number in the employer contribution rule.
The employer contribution rule criteria is defined under each sequential number. Each sequential number
is then applied separately to the complete employee contribution. The results from all the sequential
numbers are added together to form the total employer contribution.
Example:
y SEQ. NR. ER CONTR. LIMIT NET ER CONTR.
y 01 3,500 x 0.50 = 1,750 1000 1000
y 02 3,500 x 0.25 = 875 500 500
y 03 3,500 x 0.10 = 350 250 250
y --------
y TOTAL EMLPOYER CONTRIBUTION 1,750
NOTE:
y The SAP system offers only one solution to the many interpretations of employer matching. If your
company uses a different system to match employer contributions, you must implement a user exit.
For more information on user exits, search for User Exits in the Benefits IMG.
(C) SAP AG HR325 6-16

Vesting rule and schedule
80%
60%
40%
20%
0%
1 year 2 years 3 years 4 years 5 years
SAP AG 1999
The vesting rule enables you to encourage company loyalty.

The vesting schedule represents availability of employer contributions to the employee over a period of
time.
Vesting applies only to the employer contribution. The employee always has full access to employee
contributions.
(C) SAP AG HR325 6-17

Investment groups
Investment
Investment group
group 11 Gold
Gold bullion
bullion
Low
Low risk
risk // return
return
Company
Company shares
shares
Investment
Investment group
group 22
High
High risk
risk // return
return
SAP AG 1999
An investment group defines investment options within a savings plan.

When an employee enrolls in a savings plan, he or she can make choices about where contributions
should be invested.
(C) SAP AG HR325 6-18

Assign savings plan attributes
Benefits savings plan
Benefit plan STSV Standard Savings 01.01.1900 31.12.9999
Assigned rules
EE contribution rule ALL All

ER contribution rule
Vesting rule
Investment group SAV Savings
SAP AG 1999
This is the final step in defining a savings plan.

All the building blocks (employee contribution rule, employer contribution rule etc.) you have already
defined, are brought together here. Only the employee contribution rule is essential, the other three fields
may be left empty.
(C) SAP AG HR325 6-19

Combined contribution limits

for more than one savings plan
z Define mathematical equations
in two IMG steps
Define combined
contribution limit
Define combined limit
expressions
SAP AG 1999
You can define employee saving contribution limits that span more than one plan.
The system will now check these limits whenever an employee makes any choices for benefits
enrollments. This gives you much greater control over the total contributions that an employee elects.
(C) SAP AG HR325 6-20

Combined Contribution Limits for Savings
z Example 1:
Savings in Plan 1 and Plan 2 cannot exceed 10% of salary
Limit Contribution
Plan 1
0.1 X Salary >=
Plan 2
SAP AG 1999
Combined contribution limits for savings plans are set up in two steps to form an equation.
In the first step you represent the left side of the equation as an amount or as a factor of a wage type,
along with the operator for the equation.
If you enter a factor of a wage type, it will probably be a wage type that is already in use in the benefits
set-up. If not, it will need to be set up by the payroll administrator.
You may enter a rounding rule and rounding divisor and an as of date.
The second side of the equation is the plan expressions.
Example:
y The employee's total contribution to Savings plan 1 and Savings plan 2 cannot exceed 10% of salary.
y 0.1 x salary >= (1.0 x SPL1) + (1.0 x SPL2)
See the Benefits IMG for further information. Search for Combined contributions'.
(C) SAP AG HR325 6-21

z Example 2:
Savings in Plan 1 and Plan 2 cannot exceed 15,000
Limit Contribution
Plan 1
$15,000 >=
Plan 2
SAP AG 1999
Example:
y The employee's total contribution to Savings plan 1 and Savings plan 2 cannot exceed 15,000.
y 15,000 >= (1.0 x SPL1) + (1.0 x SPL2)
See the Benefits IMG for further information. Search for Combined contributions'.
(C) SAP AG HR325 6-22

Savings plans: Unit Summary
z Savings plans consist of the following:

employee contribution rule
employer contribution rule
vesting rule and schedule
investment group
z Combined limits and wage types are assigned

after the plans have been set up.
SAP AG 1999
(C) SAP AG HR325 6-23

Flexible Spending Accounts (FSAs - North America)
Contents:
z FSA general data
z Employer contribution
z Employee contribution limits
z Claims
SAP AG 1999

FSAs: Unit Objectives
z Set up a Flexible Spending Account (FSA) that

includes:
Employee contribution limit
z Define receipt types for FSA claims processing.
SAP AG 1999

FSAs: Course Overview Diagram (North America)
Basic
Concepts
Flexible
Stock Spending
Purchase Accounts
Plans (North
America)

Customizing
Tools
America)
SAP AG 1999

FSAs: Business Scenario
z Your company offers both dependent care and

health care FSAs.
z The dependent care FSA allows a maximum
annual contribution of 5,000 UNI.
z The health care FSA allows a maximum annual
contribution of 5,000 UNI.
SAP AG 1999

FSA Setup
Category FSA
FSA
Plan Type HCAR

HCAR DCAR
DCAR
Plan HLTH
HLTH DEPC
DEPC
Employer
HCTR
HCTR
contribution variant
5,000
5,000 UNI
UNI 5,000
5,000 UNI
UNI
FSA attributes
limit
limit limit
limit
SAP AG 1999
Flexible Spending Accounts (FSAs) offer employees the opportunity to set aside pre-tax money for
eligible health care and/or dependent care expenses.
Above, you can see two possible ways to set up an FSA; with or without an employer contribution rule.
The category FSA' is pre-defined by SAP. The plan type is defined in the Basic Settings section of the
Benefits IMG.
The plan, employer contribution variant and rule (optional) building blocks are all set up in the FSA
section of the Benefits IMG.

Flexible Spending Accounts (FSAs)
z tax-free dollars for health/dependent care

z minimum and maximum employee Flexible Spending
contributions accounts
z employer contribution variant
z current balance or annual contribution $
available to employee
z claims from previous year
z reimbursements
SAP AG 1999
FSAs allow employees to set aside tax-free dollars for anticipated health and dependent care expenses.
Minimum and maximum contribution amounts are defined.
FSAs normally only have employee contributions. However, it is also possible to set up employer
contributions, if required.
The employee can access either the current account balance (dependent care) or the annual contribution
(health care), depending on the type of plan.
Claims from the previous year can be processed up to a specific date.
FSA claim processing allows claims to be recorded in the system, which the payroll can then access for
reimbursements.

Define FSA General Data
Change View Benefit Flexible Spending Account General Data
Start End
DEPC Dependent Care Spending Acct 01.01.1900 31.12.9999
Benefit plan
General data
Plan type Plan number 22333589889

DCAR Dependent Care
OP Open Short text Dep. Care

Plan status
Provider
SAP AG 1999
This is the first step in defining an FSA.

Here, you define the name and the characteristics of the FSA.
The setup of employer variants, groupings and rules is the same as in the savings plan category.

Employer Contribution Variant, Grouping and Rule
Parameter
Parameter group
group
Employer
Employer
contribution
contribution
variant
variant
Employer
Employer
contribution
contribution Salary
Salary Age
Age Seniority
Seniority
grouping
grouping group
group group
group group
group
(ERCGR)
(ERCGR)
Employer
contribution rule
rule
SAP AG 1999
The employer contribution variant defines what factors influence the employer contribution an employee
is entitled to in a savings plan. It may use a parameter group, as described above, and in addition
employer contribution groupings (feature ERCGR for further differentiation between employees, based
on other employee criteria, such as geographical location, job classification, marital status etc.).
The employer contribution rule then defines the actual employer contribution of the plan for an
an employer contribution rule.
The definition of the employer contribution grouping as well as the setup of the ERCGR feature has
been explained in detail in the Savings Plans unit.

Assign FSA Attributes
Change View Benefit Flexible Spending Account

Start End
Benefit plan DEPC Dependent Care Spending Acct 01.01.1900 31.12.9999
Annual contribution limits
Minimum contribution 100.00 UNI Here,

Here,you
you define
define the
the
Maximum contribution 5,000.00 UNI annual contribution
annual contribution
range
range allowed
allowedfor
for your
your
Off-cycle plan year employees
employees by
byentering
entering
Plan year begin . aa minimum
minimum and
andaa
maximum contribution
maximum contribution
Employer contribution amount.
amount.
Contribution variant
Reimbursement of claims
BE41 Maximum availability

Reimburs. wage type
100.00 UNI Curr.account balance
Min. reimbursement
31 Annual contribution
Previous year claim to . March
SAP AG 1999
This is the final step in defining an FSA.

In this step, you define employee minimum and maximum annual contributions and the details of the
reimbursement of claims.
You can make use of an off-cycle plan year by defining the off-cycle plan year begin date to override the
calendar year as the cumulation year. If you leave these fields empty, the system always assumes
January, 1st.
If you have defined an employer contribution variant, you assign it here to the plan.
You have to define a wage type for the reimbursement of claims.
You can define a minimum claim amount before the employee can receive a reimbursement. The
exception to this is at year end, when all claims are settled.
You can also define how long an employee may still claim reimbursement for bills dating from the
previous year. The end of the grace period is defined by a day/month combination.
Under Maximum availability, you can specify whether the whole annual contribution (health care) or
only the current account balance (dependent care) is available for claims.

Define Receipt Types for FSA Claims Processing
Change View Benefit Payment Receipt Type

Receipt type Text
DAYC Day care
DOCT Doctor visit
HOSP Hospital visit
MEDC Medicine FSA
FSA Claims
Claims Infotype
Infotype (0172)
(0172)
Create Spending Account Claims
Customizing
Customizing view
view Personnel no
4401
Name Rose Salizar
...
Plan type Dependent Care
Benefit plan Dependent Care Spending Acct
Claim data
Claim date 15.12.1999 Cancellation
Date cost incurred 09.12.1999 Claim cancelled
Claim 300.00 UNI Agreement to cancellation
Claim on hold
Receipt type Daycare
Receipt number 1
Provider name Spindles Kindergarten
SAP AG 1999
In this step, you enter the receipt types for FSA claims processing.
These receipt types can then be used in the FSA Claims records (infotype 0172) and are fully
customizable.
FSA claims processing will be covered in the Benefits Processing unit.
(C) SAP AG HR325 7-10

FSA claims processing
00004401 Marita Bond

United States SubsidiActive employee
PSA 0001 Salaried employees 343-43-4995
Chngd 16.01.1998 WALDEN
Benefit plan type DPSD DEPEND CARE

Benefit plan DPSD DEPENDENT CARE SPENDING ACCT
Claim data
Claim submitted on 16.01.1998
Cancellation
Date cost incurred 16.01.1998
Claim cancelled
Claim 100.00 USD
Agreement to cancel
Claim on hold
Receipt type DAYC DAYCARE

Receipt number 1
R
SAP AG
This is the FSA Claims (infotype 0172) where the receipt type is used.
FSA claims processing is covered in the Benefits processing unit. For more information on this subject,
refer to R/3 System online help: Benefits Administration. Search for FSA claim processing.
(C) SAP AG HR325 7-11

FSAs: Unit Summary

z Set up a Flexible Spending Account
(FSA) that includes:
Employee contribution limit
z Define receipt types for FSA claims

processing.
SAP AG 1999
(C) SAP AG HR325 7-12

Credit Plans
Contents:
z Credit plan general data

z Credit variants and rules
z Excess credit
SAP AG 1999

Credit Plans: Unit Objectives
At the conclusion of this unit,

you will be able to:
z Set up a credit plan that includes a credit variant and

rule.
z Describe the relationship between credit plans and
other benefit plans.
z Explain the purpose of the excess field and
assign an excess percentage to a
credit plan.
SAP AG 1999

Credit Plans: Course Overview Diagram
Basic
Concepts
Flexible
Stock Spending
Purchase Accounts
Plans (North
America)

Customizing
Tools
America)
SAP AG 1999

Credit Plans: Business Scenario
z Employees are allowed to use their credit to pay

for:
health plans
insurance plans
miscellaneous plans (only with costs)
z Each employee receives a certain percentage of
his/her base salary depending on their seniority
and on whether they are salaried or hourly paid
employees.
SAP AG 1999

Credit Plan Setup
Category CREDIT
CREDIT
Plan Type CRED

CRED
Plan FLEX
FLEX
Credit variant SIMP

SIMP
SAP AG 1999
The category Credit is pre-defined by SAP. The plan type is defined in the Basic settings section of the
Benefits IMG.
The plan and the credit variant are both set up in the Credit plans section of the IMG.

Define Credit Plan General Data
Change View Benefit Credit Plan General Data: Details
Start End
FLEX 01.01.1900 31.12.9999

Benefit plan Flexible credit plan
General data
Plan type CRED Credit Plan Plan number 98897765

Plan status OP Open Short text FlexCredit
Provider
SAP AG 1999
This is the first step in defining a credit plan.

Here, you define the name and the characteristics of the credit plan.

Credit Variant, Grouping and Rule
Parameter
Parameter group
group
Credit
Credit
variant
variant
Credit
Credit Salary
Salary Age
Age Seniority
Seniority
grouping
grouping group
group group
group group
group
Credit
Credit rule
rule
SAP AG 1999
The credit variant defines what factors influence the credit an employee is entitled to use for his/her
plans. It may use a parameter group, as described above, and in addition credit grouping (feature
CRDV1) for further differentiation between employees, based on other employee criteria, such as
geographical location, job classification, marital status etc.).
The credit rule then defines the actual credit for an employee who may have any combination of the
above criteria. For each combination, you must define a credit rule.

Credit Grouping Feature - CRDV1
Employee
Benefit Credit Grouping
Credit grouping Description
HRLY Hourly paid
SLRY Salaried
Benefit
Benefit
area
area
Benefit
Benefit Benefit
Benefit
plan
plan plan
plan

Employee
Zip
Zip code
code group
group group
group
AREA1 AREA2 HRLY

AREA1 AREA2 SLRY TEMP
HRLY SLRY TEMP Union
Union A
A Union
Union B
B
SAP AG 1999
The credit grouping allows you to include other credit criteria, which are not included in the credit
variant.
The credit grouping feature's technical name is CRDV1.
The credit grouping feature, as all other features, processes the data of each employee, one at a time and
allocates him or her to the correct credit grouping.

Define Credit Grouping & Set up Feature
Benefit Credit Grouping

Credit grouping Description
HRLY Hourly paid
Feature
SLRY Salaried
Process feature CRDV1: decision tree

CRDV1 CRDV1 Credit grouping
BAREA Benefit area
After defining a credit 99 Internation. Basic
grouping, you must set up BPLAN Benefit plan

the CRDV1 feature. FLEX
PERSK Employee subgroup
X1 Hourly rate/wage
HRLY
SLRY
SAP AG 1999

In this example, the feature is making decisions on benefit area (BAREA), benefit plan (BPLAN), and
employee subgroup (PERSK).
The credit groupings being assigned here are HRLY and SLRY.
You define the credit groupings and set up the feature under Define employee groupings Define credit
groupings in the Benefits IMG.

Credit Rules
Credit
Credit Grouping
Grouping
Union Hourly
Union A
A Union
Union B
B Salaried
Salaried
paid
00 -- 22
years
years
group
Seniority group
33 -- 55
years
years
Seniority
66 -- 10
10
years
years
10>
10>
years
years
SAP AG 1999
You must define a credit rule for every possibility within the credit variant. If you have not defined any
criteria in the credit variant, you have to define exactly one rule for this variant.
An employee's personal data places him or her in exactly one of the credit rules.
Example:
y Each box in the diagram represents a credit rule.
y The dark box represents a credit rule applicable to employees:
Note:
(C) SAP AG HR325 8-10

Assign Credit Plan Attributes
Define excess
Assign
Assign previously
previously
defined
defined credit
credit variant.
variant.
Plan Text Start date End date CrdVar Credit variant text Excess %
FLEX Flexible credit plan 01.01.1900 31.12.9999 CRV1 Credit variant 1 50
FLX1 Flex Credit Plan 1 01.01.1900 31.12.9999 CRD1 Credit variant Flex 1 50
FLX2 Flex Credit Plan 2 01.01.1900 31.12.9999 NEW New variant 100
z Excess credit defined here for FLEX plan:

Return 50% of the excess credit.
SAP AG 1999
This is the final step in defining a credit plan. The credit variant which you have already defined is
assigned to the plan.
You can specify a return percentage for unused credit amounts. This employee percentage of excess
credit amount field refers to an employee's unused credit. If there is any credit remaining once other
plans have been paid for, the employee is entitled to receive the specified percentage of excess credit in
cash.
(C) SAP AG HR325 8-11

Credit Examples
Plan Credit Cost Credit Excess

indicator Credit
MED1 50
LIF1 10
CAR1 70
FLXA 100 50%
FLXB 30 100%
FLXC 200 30%
SAP AG 1999
Credit can be used to pay for health, insurance and miscellaneous plans (only with costs).
To indicate that a plan may be paid for with credits, the plan has the credit indicator selected when it is
first defined (See the IMG under Define health (etc.) plan general data).
Cost is defined in the cost variants for each plan. Credit is defined in the credit variant and excess credit
is defined in the credit plan.
Examples:
FLXA FLXB FLXC
y EE costs/
can use credits 50+70 = 120 50+70 = 120 50+70 = 120
y Credit = 100 = 30 = 200
y Costs-credits 120-100 = 20 120-30 = 90 120-200 = -80
y Excess % = 0 = 0 30% x -80 = -24
y EE cost/
cannot use credits = 10 = 10 = 10
y EE pays 20+10 = 30 90+10 = 100 (30%x-80)+10 = -14
(C) SAP AG HR325 8-12

Credit Plans: Unit Summary
z Set up a credit plan that includes a

credit variant and rule.
z Describe the relationship between
credit plans and other benefit plans.
z Explain the purpose of the excess field
and assign an excess percentage to a
credit plan.
SAP AG 1999
(C) SAP AG HR325 8-13

Miscellaneous Plans
Contents:
z Miscellaneous plan general data

z Different kinds of plans using different
building blocks from other plan categories
SAP AG 1999

Miscellaneous Plans: Unit Objectives
z Describe the different kinds of miscellaneous plans:

Cost/credit-relevant (providing a service)
Contribution-relevant (a financial plan)
z Set up a miscellaneous plan that includes
Cost variant
SAP AG 1999

Basic Settings Insurance

Benefits
Benefits Customizing Health Savings
Savings
and Common Plans
Overview
Overview Benefits Plans plans plans
Plans
Concepts
Stock
Credit Credit
Miscellaneous Miscellaneous Flexible
Benefits Benefits
Reports
Purchase Administration
plans Plans
plans Plans Administration
processing Processing
and tools
Plans
Benefits
Benefits
Reporting and Payroll
integration
Customizing Integration
to Payroll
Tools
SAP AG 1999

Miscellaneous Plans: Business Scenario
z Your company offers a company car. Employees

can choose between a standard and a luxury car.
Employees pay a higher premium if they live
beyond a 20 mile radius of the office.
z Your company also offers Health Club
membership. The flat monthly cost is the same for
all employees.
SAP AG 1999

Miscellaneous Plan Setup
Category MISCELLANEOUS
MISCELLANEOUS
Plan Type CAR

CAR CLUB
CLUB CHAR
CHAR
Plan CAR
CAR CLUB
CLUB CHAR
CHAR
Option STRD
STRD LUXY
LUXY CLUB
CLUB CHAR
CHAR
Cost variant STRD

STRD LUXY
LUXY 100
100 flat
flat amt.
amt.
Employee contribution 5%
5% of
of salary
salary
Employer contribution 10
10 UNI
UNI
SAP AG 1999
Miscellaneous plans allow you to administer plans that do not fit neatly into the other categories of
health, insurance, savings, stock purchase or credits. Examples of Miscellaneous plans are Company Car
or Health Club Membership.
Miscellaneous plans are the most versatile of plans because they can be set up using the five main
building blocks (cost variant, coverage variant, etc.) from all other plan categories.
Above, you can see three possible ways to set up a miscellaneous plan.
The category Miscellaneous is pre-defined by SAP. The plan type is defined in the Basic Settings section
of the Benefits IMG.
The building blocks are all set up in the Miscellaneous Plans section of the Benefits IMG.

Define Miscellaneous Plan General Data
Change View Benefit Miscellaneous Plan General Data: Details
Start End
CAR 01.01.1900 31.12.9999

Benefit plan Company Car
General data
Plan type CAR Company Car Plan number 18897734
Plan status OP Open Short text CompCar

Provider Assign
Assign dependent/
dependent/
beneficiary
beneficiary group
group
MIscellaneous plan attributes
Dependent relevant Benefic. relevant Selection groups

Contingency benefic.
Cost/credit rel. Contr. relevant

Cover. variant Pre-tax allowed EE contr. relevant Set
Set up
up dependent/
dependent/
Cost variant Post-tax allowed ER contr. relevant beneficiary
beneficiary group
group
Credit variant Credits allowed Investments feature
feature (RLPGR)
(RLPGR)
ER costs are not credited to employee Vesting rule
Service
Service plan
plan Financial
Financial plan
plan
SAP AG 1999
Here, you define the name and the characteristics of a miscellaneous plan. You decide if the plan is:
- cost/credit-relevant (providing a service)
- contribution-relevant (a financial plan)
This defines which sections of miscellaneous plans must be set up in the Benefits IMG.
In the case of a cost/credit-relevant plan, you can define
y coverage/cost/credit variants and rules
In the case of a cost/credit-relevant plan, you can define
y employee / employer contribution variants and rules
y investments and investment groups
y vesting rules and vested portions
You specify if dependents, beneficiaries and/or contingency beneficiaries are relevant to the plan. You
can also restrict the number of possible dependents/beneficiaries by assigning a dependent/beneficiary
group to the plan. For this group, you then have to set up the RLPGR feature to dynamically sort
family/related persons (infotype 0021) into the correct group at enrollment. This has been explained in
detail in the Basic Settings & Common Concepts unit.

Two kinds of miscellaneous plans
Credit by length of service Cost/credit

at 5 years, 10 years, ... > cost
Coverage by amount ...
> credit
Flat Cost for club
membership ... > coverage
Employee contribution
2% to 5% of salary Contribution relevant
Employer contribution > employee contribution
50% match, 100% match ...
> employer contribution
Vesting at 25% after 2 years, 50%
after 4 years, 100% after 6 years > vesting
Savings investments in Equity > investments
plan, Fixed Income plan, etc.
SAP AG 1999
Other system parameters are set up in a similar way in following steps to permit maximum flexibility in
accommodating the wide variety of benefit plans:
- Define credit formulas and rules to determine what factors influence the credit allocated to an
employee.
- Define coverage formulas to determine what factors influence the amount of coverage an employee
receives.
- Define Employee contribution rules and rule criteria to determine how much the employee
contributes to contribution relevant plans.
- Define Employer contribution rules and rule criteria to determine how much the employer
contributes to contribution relevant plans.
- Define vesting rules and schedule.
- Determine investment options allowed.

Miscellaneous Plans - Example
Far
over 20 miles from work Define cost groupings,
by zip code (NEAR and FAR)
Near
20 miles or less from work
Define cost variants

(STRD and LUXY)
SAP AG 1999
The Company Car plan has two plan options: standard and luxury car. Each option has a flat monthly
cost, which varies according to how far employees live from their place of work.
The cost grouping feature is set up dividing employees by zip code for this plan:
y NEAR - employees living up to 20 miles from work
y FAR - over 20 miles from work
The 3 cost variants for the plan are set up as follows:
y STRD - Standard Car - period 'monthly' and cost grouping selected
y LUXY - Luxury Car - period 'monthly' and cost grouping selected

Miscellaneous Plans - Example (Cont.)
Define cost rules
Cost grouping
Cost variant
160 UNI 180 UNI
300 UNI 330 UNI
SAP AG 1999
In the cost rule, you define the actual costs for a miscellaneous plan. For every possible combination of
criteria that you have defined in the cost variant, you enter the actual costs.
Example:
y The cost rules are set up as follows:
y STRD - NEAR: 160 UNI
y STRD - FAR: 180 UNI
y LUXY - NEAR: 300 UNI
y LUXY - FAR: 330 UNI

Assign Miscellaneous Plan Attributes
Assign miscellaneous plan attributes
For
Forcost/credit-relevant
cost/credit-relevantplans,
plans,you
youcan
canassign:
assign:
cost variants
credit variants
coverage variants
For
Forcontribution-relevant
contribution-relevantplans,
plans,you
youcan
canassign:
assign:
EE contribution variants
ER contribution variants
investment groups
vesting rules
SAP AG 1999
In the final IMG step for Miscellaneous Plans, you define the plan's options and bring together all the
building blocks you have already defined before.
Depending on what kind of miscellaneous plan it is, the system only allows you to assign the correct
variant and rules:
- If the plan is cost/credit-relevant, you can assign cost, credit and coverage variants.
- If the plan is contribution-relevant, you can assign employee and employer contribution variants,
vesting rule and investment group.
(C) SAP AG HR325 9-10

Miscellaneous Plans: Unit Summary
z Describe the different kinds of

miscellaneous plans:
Cost/credit-relevant (providing a service)
Contribution-relevant (a financial plan)
z Set up a miscellaneous plan that
includes
Cost variant
SAP AG 1999
(C) SAP AG HR325 9-11

Contents:
z Pre- and corequisite plans

z Benefit programs
z Eligibility and termination
z Standard plans
z Adjustment reasons
z Administrative parameters
z Forms
SAP AG 1999
(C) SAP AG HR325 10-1

Flexible Administration: Unit Objectives
z Set up prerequisite and corequisite plans.

z Set up benefit programs.
z Set up eligibility and termination variants and rules.
z Define standard plans (default/automatic).
z Define adjustment reasons and permissions.
z Set up administrative parameters.
z Describe how to set up benefit
forms.
SAP AG 1999
All the settings made in this unit, can be found in the Benefits IMG under Flexible Administration.
(C) SAP AG HR325 10-2

Flexible Administration: Course Overview Diagram
Basic
Concepts
Flexible
Stock Spending
Purchase Accounts
Plans (North
America)

Customizing
Tools
America)
SAP AG 1999
(C) SAP AG HR325 10-3

Pre- and Corequisite Plans: Topic Objectives
At the conclusion of this topic, you will be able to:
z Define and set up pre- and corequisite plans.

z Explain the difference between the every and any
requirements.
SAP AG 1999
All the settings made in this topic, can be found in the Benefits IMG under Flexible Administration
Prerequisites and corequisites.
(C) SAP AG HR325 10-4

Pre- and Corequisite Plans: Business Scenario
z Certain insurance plans that your company offers

require the employee to be covered by other plans:
Under the terms of the Life Insurance Contract, in
your company an employee is required to have been
enrolled in the Basic life insurance plan before they
are permitted to enroll in the Supplemental life plan.
Under the terms of the Medical/Dental Insurance
Contract, your company cannot permit anyone to
enroll into the Dental plan without either first being
enrolled, or elect at the same time, the medical
coverage.
SAP AG 1999
(C) SAP AG HR325 10-5

Prerequisite and Corequisite Plans
Prerequisite Corequisite
Plan
Plan A
A Plan
Plan A
A
Validity
begin
date
-1
Plan
Plan B
B Plan
Plan B
B
Corequisite Plan B enrolled
Prerequisite Plan B enrolled in or selected at the begin
in one day before validity date of the validity period of
begin date of Plan A Plan A
SAP AG 1999
For certain plans in which employees may enroll, you can define other prerequisite and/or corequisite
plans:
Example:
y Prerequisite plan B is a plan an employee must already be enrolled on the day before the validity begin
date of plan A. This condition is checked in enrollment.
y Corequisiste plan B is a plan which the employee must have selected or be enrolled in at the begin
date of the validity period of plan A. This condition is checked in enrollment. Checks that the
corequisite plan condition is still fulfilled at later points in time during the validity period of plan A
can be carried out using the Eligibility Monitor.
(C) SAP AG HR325 10-6

Define Prerequisite and Corequisite Plan
Change View Benefit Prerequisite Plan: Overview
Benefit plan SLIF Supplemental Life Insurance

Plan
Plan is
is firmly
firmly required.
required. There
There is
is
no other plan the employee
no other plan the employee cancan
Benefit Prerequisite Plan choose
choose asas pre-
pre- or
or corequisite.
corequisite.
PrereqPlan Text Every plan required Any plan required
DEPL Dependent Life Insurance
ALIF Additional Life Insurance
Plan
Plan belongs
belongs to
to aa group
group of
of
LIFE Standard Life Insurance
plans of which an employee
plans of which an employee
must
must choose
choose or
or have
have at
at least
least
one.
one.
Change View Benefit Corequisite Plan: Overview
Benefit plan DENT Standard Dental Plan
Benefit Corequisite Plan
Coreq.plan Text Every plan required Any plan required

STMD Standard Medical Plan
MED2 Medical Plan 2
SAP AG 1999
Define prerequisite plans:

y In the example shown above, for the employee to be able to enroll in the Supplemental Life Insurance
plan, he/she must already be enrolled in the Life Insurance plan and either Additional or Dependent
Life Insurance plan.
Define corequisite plans:
y In the example shown above, an employee wants to participate in Standard Dental plan. He/she must
also have selected either Medical Plan 1 or Medical Plan 2 at the time of enrollment into Standard
Dental.
(C) SAP AG HR325 10-7

Programs, Eligibility, Termination: Topic Objectives
z Group employees into benefit programs.

z Interpret the features BENGR and BSTAT.
z Create a benefit program for a group of employees.
z Create eligibility and termination rules.
z Interpret the eligibility feature ELIGR and the
termination feature TRMTY.
z Define zip code groups as eligibility criteria.
z Describe actual hours used as an
eligibility criterium.
z Assign eligibility and termination
rules to plans within programs.
SAP AG 1999
Programs.
(C) SAP AG HR325 10-8

Programs, Eligibility, Termination: Business Scenario
z Your company offers different benefit plans

depending on the type of employee.
z A particular plan is shared by different groups of
employees. Full time employees are eligible
immediately and part time employees have a
waiting period of 6 months until they are eligible.
Termination is in both cases immediate.
SAP AG 1999
(C) SAP AG HR325 10-9

First Program Grouping Feature - BENGR
First Program Grouping Employee

1st Program grouping 1st PrGrp. text
EXEC Executives
SLRY Salaried employees
HRLY Hourly paid
Benefit
Benefit
area
area
Benefit
Benefit Benefit
Benefit
plan
plan plan
plan

Employee
Zip
Zip code
code
subgroup subgroup subgroup
subgroup
Early
Early
A
A B
B EXEC
EXEC SLRY
SLRY HRLY
HRLY Retired
Retired retired
retired
SAP AG 1999
The first program grouping feature's technical name is BENGR.

The first program grouping allows you to sort employees into different groups, depending on which
plans you offer to different groups of employees.
The first program grouping is one dimension of the benefit program definition.
Example:
An organization offers one set of benefit plans for hourly-paid employees and a different set for salaried
employees. Hourly-paid employees may enroll in medical, dental and life insurance plans after a four
month waiting period. Salaried employees may enroll in medical, dental, life and vision plans after a one
month waiting period.
(C) SAP AG HR325 10-10

Define First Program Grouping & Set up Feature
Change View Benefit First Program Grouping

1st Program grouping 1st PrGrp. text
EXEC Executives
SLRY Salaried employees
HRLY Hourly paid
Feature
Process feature BENGR: decision tree
BENGR BENGR First program grouping

BAREA Benefit area
After defining a first program
grouping, you must set up 99 Internation. Basic
the BENGR feature. PERSK Employee subgroup
X1 Hourly rate/wage
HRLY
SLRY
otherwise
EXEC
SAP AG 1999
This is how a feature can actually be set up in the system.

In this example, the feature is making decisions on benefit area, employee group and employee
subgroup.
The first program groupings being assigned here are HRLY, SLRY and EXEC.
(C) SAP AG HR325 10-11

Second Program Grouping Feature - BSTAT
Employee
Benefit Second Program Grouping
2nd Program group. 2nd PrGrp. text
FULL Full Time
PART Part Time
TEMP Temporary
Company
Company
code
code
Employee
Employee Employee
Employee
subgroup
subgroup subgroup
subgroup
Hours per Hours per Employment

Employment
Union
Union week week contract
contract
A
A B
B FULL
FULL PART
PART TEMP
TEMP Clerical
Clerical Executive
Executive
SAP AG 1999
The second program grouping feature's technical name is BSTAT.

The second program grouping allows you to sort employees into different groups, depending on which
plans you offer to different groups of employees.
The second program grouping is one dimension of the benefit program definition.
(C) SAP AG HR325 10-12

Define Second Program Grouping & Set up Feature
Change View Benefit Second Program Grouping

2nd Program group. 2nd PrGrp. text
FULL Full Time
PART Part Time
Feature
Process feature BSTAT: decision tree

After defining a second program BSTAT BSTAT Second program grouping
grouping, you must set up BAREA Benefit Area
the BSTAT feature.
WOSTD ? 20 Hours per week compared

with 20
< (smaller)
PART
otherwise
FULL
SAP AG 1999

In this example, the feature is making decisions on benefit area and hours per week.
The second program groupings being assigned here are PART and FULL.
(C) SAP AG HR325 10-13

Macro Eligibility: Programs
Display IMG
First program grouping Basic Settings
Plans
EXEC SLRY HRLY Flexible Administration
Define administrative parameters
grouping
program grouping
Prerequisites and corequisites

FULL
FULL Programs
Define first program grouping
Define second program grouping
Second program
Employee eligibility
PART
PART Participation termination
Define benefit programs
Second
Program
TEMP Plan Var.
TEMP DENT ELI1
INS1 ELI1
LIFE ELI2
MED1 ELI2
... ...
SAP AG 1999
A program is a restricted list of plans available to a specific group of employees.

The features first program grouping and second program grouping place an employee into a particular
program.
You do not have to define a program for every combination of first program grouping and second
program grouping.
(C) SAP AG HR325 10-14

Micro Eligibility: Variant and Grouping Definitions
Eligibility grouping Employee

Group. Description
ALN Alien
CTZN Citizen
NCTZ No Citizen
Benefit
Benefit
area
area
Job
Job Job
Job
key
key key
key
Union
Union Employee Employee Employee
Employee
number
number group group group
group
Eligibility variant
Eligibility variant Description
ELI1 Eligibility 1
ELI2 Eligibility 2
Eligibility rule
ELI3 Eligibility 3
ELI4 Eligibility 4 Waiting period
Minimum working time
Restrictions
SAP AG 1999
The benefit program gives the plans an employee is eligible for. This is macro eligibility.
The eligibility variants are applied to plans within a program to provide the micro eligibility.
Each employee can have a different eligibility rule depending on the combination of his or her eligibility
grouping and eligibility variant.
The eligibility grouping feature enables you to group employees according to their personal data.
The eligibility grouping feature's technical name is ELIGR.
(C) SAP AG HR325 10-15

Define Eligibility Grouping & Set Up Feature
Change View Benefits Eligibility Grouping

Grouping Description
ALN Alien
CTZN Citizen
NCTZ No Citizen Feature
Process feature ELIGR: decision tree
ELIGR ELIGR Eligibility grouping
BAREA Benefit area

After defining an eligibility
grouping, you must set up 99 Internation. Basic
the ELIGR feature. RESIS Residence status
C
CTZN
N
NCTZ
otherwise
ALN
otherwise
SAP AG 1999

In this example, the feature is making decisions on benefit area (BAREA) and residence status (RESIS).
The eligibility groupings being assigned here are CTZN, NCTZ and ALN.
(C) SAP AG HR325 10-16

Eligibility Rule
Eligibility
Eligibility variant
variant
ELI1
ELI1 ELI2
ELI2 ELI3
ELI3 ELI4
ELI4
CTZN
CTZN
grouping
Waiting period Waiting period Waiting period

Eligibility grouping
Minimum Minimum Minimum

work hours work hours work
Restrictions Restrictions R
Display IMG
Waiting period Benefits Administration
NCTZ
NCTZ Waiting period Waiting period Basic Settings
Eligibility
Minimum Minimum Minimum Display IMG

Plans
work hours work hours
working time
Restrictions Restrictions Flexible Administration
Restrictions Define administrative parameters
ALN
ALN Wait Prerequisites and corequisites
Minimum Programs
work hours
Restrictions
Define second program group.
Define eligibility groupings
Define eligibility variants
Actual hours
Define date types
Assign act. hours cond. to
Zip codes
Define zip code groups
Assign zip codes to groups
Define eligibility rules

SAP AG 1999
You have to define eligibility rules for every possible combination of eligibility variant and eligibility
grouping.
The eligibility rule consists of:
- waiting period
- minimum working hours
- age and zip code restrictions
Each eligibility variant must incorporate at least one eligibility grouping.
The eligibility variants are later assigned to plans in the benefit program. From there, the variant points
to different eligibility criteria, depending on the employees eligibility grouping. If the eligibility rules for
a particular eligibility variant and grouping combination has not been defined, then the employee is not
eligible for the plan.
(C) SAP AG HR325 10-17

Macro Eligibility Linked to Micro Eligibility
Benefit Program
Plan Variant Variant ELI2
DENT ELI1 Grouping ALN
INS1 ELI1
Waiting period
LIFE ELI2
MED1 ELI2 Variant ELI2
... ...
Grouping CTZ
Waiting period
Hire date override
Enrollment
Minimum working time
Restrictions
SAP AG 1999
Within a program, you can use the eligibility variant to further restrict who may enroll in a particular
plan.
The eligibility variant is the link between macro and micro eligibility.
(C) SAP AG HR325 10-18

Termination is Eligibilitys Mirror Image ...
Eligibility
Eligibility Termination
Termination
SAP AG 1999
Termination is the mirror image of eligibility.

Just as eligibility determines when an employee starts participating in a benefit plan, termination defines
when he or she stops.
Major parts of the eligibility concept are also used for termination.
(C) SAP AG HR325 10-19

Termination: Variant and Grouping Definitions
Employee
Termination grouping
Termination grouping Description
DTH Death
EETM Employee termination
Benefit
Benefit
ERTM Employer termination area
area
RETI Retirement
TTYP Standard Type Action
Action Action
Action
type
type type
type
Employee Action Action Action

Action
Employee
status reason reason reason
reason
status
Termination variant
Termination variant Description Termination rule
TRM1 Termination 1
Termination 2
TRM2
Coverage continuation period
TRM3 Termination 3
Termination
SAP AG 1999
Termination and eligibility are set up symmetrically in the benefits system. Where an eligibility variant
specifies the waiting period before an employee may start participating in a benefit plan, termination
specifies when the employee stops participating.
The termination grouping feature enables you to group employees according to their personal data. The
termination grouping feature's technical name is TRMTY.
The termination variants are applied to plans.
Each employee can have a different termination rule depending on the combination of his or her
termination grouping and termination variant.
(C) SAP AG HR325 10-20

Define Termination Grouping & Define Feature
Change View Benefits termination grouping

Termination grouping Description
DTH Death
Feature
EETM Employee termination
ERTM Employer termination Process feature TRMTY: decision tree
RETI Retirement
TTYP Standard Type TRMTY TRMTY Feature for Termination Type
BAREA Benefit area
MASSN Action type

After defining a termination 10 Leaving
grouping, you must set up
MASSG Reason for action
the TRMTY feature.
01 Notice of termination by EE
EETM
02 Notice of termination by ER
ERTM
09 Death of employee
DTH
14 Early retirement
MASSG Reason for action
otherwise
RETI
SAP AG 1999

In this example, the feature is making decisions on benefit area (BAREA), action (MASSN) and action
reason (MASSG).
The termination groupings being assigned here are EETM, ERTM, DTH, and RETI.
(C) SAP AG HR325 10-21

Termination Rule
Display IMG
Basic Settings
Plans
Termination grouping Flexible Administration
EETM ERTM DTH RETI Prerequisites and corequisites

Programs

Define second program group.
TRM1
TRM1 Coverage Coverage Coverage
Coverage
variant
continuation
Termination variant
continuation continuation continuation

Termination on Termination on Termination on
Termination on
Participation termination
Define termination groupings
Termination
Cov. continuation Define termination variants

TRM2
TRM2 Coverage
continuation
Coverage
continuation Define termination rules
Termination on
Termination on Termination on
Define benefit programs
TRM3
TRM3 Coverage
continuation
Coverage
continuation
Coverage
continuation
Coverage
continuation
Termination on Termination on Termination on Termination on
SAP AG 1999
For every possible combination of termination grouping and termination variant, you must define a
termination rule.
(C) SAP AG HR325 10-22

Termination Variant in the Program
Benefit Program
Term. variant TRM2
Plan Variant
Term. grouping EETM
DENT TRM1
INS1 TRM1 Coverage continuation period
LIFE TRM2
MED1 TRM2 Term. variant TRM2
... ... Term. grouping ERTM
Coverage continuation period

Termination date override
Termination
SAP AG 1999
Within a program, you can use the termination variant to define when the plan participant terminates
enrollment.
(C) SAP AG HR325 10-23

Eligibility and Termination Variants in the Program
Display IMG
First program grouping Benefits Administration
Basic Settings
EXEC SLRY HRLY Plans
grouping
program grouping

FULL
FULL Prerequisites and corequisites
Programs
Second program
Define second program grouping

PART
PART Employee eligibility
Participation termination
Program
Define termination groupings
Second
Plan Elig Term

Define termination variants
TEMP
TEMP DENT ELI1 TRM1
Define termination rules
INS1 ELI2 TRM1
LIFE ELI1 TRM2 Define benefit programs
MED1 ELI1 TRM2
... ... ...
SAP AG 1999
A benefit program is a list of benefit plans in which a member of a first program grouping and second
program grouping can participate, if they fulfill the eligibility rule requirements associated with the plan.
The program also displays the eligibility and termination variants associated with the plan.
(C) SAP AG HR325 10-24

Standard Plans: Topic Objectives
z Describe the difference between automatic and

default plans.
z Define standard plans (automatic or default) for
each category.
z Display an overview of all standard plans per
benefit area and plan category/type.
SAP AG 1999
Standard selections.
(C) SAP AG HR325 10-25

Standard Plans: Business Scenario
z Your company enrolls employees in the Standard

Medical, Standard Dental and Standard Insurance
plan by default, if they do not select an option by
the last day of the first month of employment.
SAP AG 1999
(C) SAP AG HR325 10-26

Standard Plans
Automatic Coverage Default Coverage

Time Time
No consent or election Temporary,

required pre-election choice
SAP AG 1999
You can enroll employees in two varieties of Standard plans: automatic and default.
- Automatic plans refers to those plans you enroll an employee in, without requiring the person to
make any decision to enroll, or make any option choices. These plans are typically provided at no
extra cost to the employee, although this is not exclusively the case.
- Default plans are those the employee is enrolled in, typically before the Benefits office has received
the employee's enrollment form with his or her benefits choices. Default plans are particularly
useful for giving short-term coverage to new hires.
Both automatic and default plans can be changed in the open offer or in an adjustment offer.
(C) SAP AG HR325 10-27

Define Standard Plan and Standard Plans Overview
Display IMG
Change View Benefits Standard Health Selection
Basic Settings 1stProgrGrp. HRLY Hourly
Plans
2ndProgGrp. FULL Full-time
Plan type MEDI Medical
Prerequisites and corequisites
Benefit plan MED1 Medical Plan 1 Processing type
Programs
Standard selections OPT1 Option 1 Automatic plan
Option
Define standard health selections Default plan
Dependent cov. EE Employee only
Define standard insurance selections
Define standard savings selections
Define standard stock purch. selections
Define standard spending acc. selections Standard Plans Overview
Define standard credit selections Standard plans
Define standard miscellaneous selections Benefit area 99 Internation. Basic
Overview of standard selections Plan category A Health plan
1stProGrp 2ndProGrp Plan type Plan Enrol.type Option Dep.cover.
EXEC FULL DENT DENT Default plan OPT1 EE
MEDI MED1 Default plan OPT1 EE
PART MED1 Default plan OPT1 EE

per
per benefit
benefit area
area and
and SLRY FULL DENT DENT Default plan OPT1 EE
plan
plan category/type to
category/type to check
check MEDI MED1 Default plan OPT1 EE
that PART MED1 Default plan OPT1 EE

that your
your entries
entries for
for automatic
automatic
HRLY FULL MED1 Default plan OPT1 EE
and
and default
default plans
plans are
are correct.
correct.
PART MED1 Default plan OPT1 EE
SAP AG 1999
You can define standard plans for every combination of first and second program grouping, just as the
programs are defined.
Then you enter the plan and plan attributes in which the employee is enrolled during standard plan
processing. Here, you have to decide, whether it is an automatic or a default plan.
The Standard Plans Overview report gives you an overview of customized Standard Plans. You can use
it to check that the entries for default and automatic plans, under each benefit plan category are correct.
(C) SAP AG HR325 10-28

Adjustment Reasons: Topic Objectives
z Give examples of life or work-related changes that

trigger benefit adjustment reasons.
z Give examples of ways employees may be grouped
into benefit adjustment groupings for processing of
benefit adjustment reason.
z Interpret the adjustment grouping feature EVTGR.
z Set up the permissions for a benefit
adjustment reason.
z Display an overview of all adjustment
permissions per benefit area
and plan category/type.
SAP AG 1999
Benefits adjustment reasons.
(C) SAP AG HR325 10-29

Adjustment Reasons: Business Scenario
z Your company decides to define the following

adjustment reasons to trigger enrollment or changes
to enrollment:
Hiring
New dependent
Marriage
SAP AG 1999
(C) SAP AG HR325 10-30

Adjustment Reasons and Adjustment Offer
Changes to enrollments for each adjustment reason:
z Life Event Examples: Birth of a child, Marriage

z Work Event Examples: Hiring, Organizational Reassignment
SAP AG 1999
Adjustment processing
y This functionality allows you to process changes to employee enrollments depending on the
permissions granted for each adjustment reason.
y An adjustment reason is a change in the employee's circumstances, that require changes to his or her
benefits elections. The adjustment might be a life change such as a new baby, or a work-related
change such as being hired in a new company or being promoted.
y Adjustment reasons allow you to track these occurrences, and make only those changes to employee
elections which are permitted according to company policy.
Before you begin this processing, an Adjustment reasons record (infotype 0378) must exist for the
employee. This might have already been created during HR Personnel Administration processing, or you
can create one manually in Managing Employee Master Data. This record is not required only if the
adjustment reason is defined in Customizing as an anytime adjustment reason, which permits changes
within no time limit.
(C) SAP AG HR325 10-31

Adjustment Grouping Feature - EVTGR
Employee
Define Adjustment grouping
Adjustment grouping Text
FULL Full time employees
OTHR All other employees
Benefit
Benefit
area
area
Employee
Employee Employee
Employee
group
group group
group
Employment Employment Employment

Union
Union contract contract contract
A
A B
B FULL
FULL OTHR
OTHR ...
... ...
... ...
...
SAP AG 1999
The adjustment grouping feature's technical name is EVTGR.

The adjustment grouping feature enables you to group employees according to their personal data.
For each combination of adjustment grouping and adjustment reason, you can later specify a set of
adjustment permissions.
This means that for different groups of employees who might, for example, experience the adjustment
reason New child', you can specify different event permissions.
(C) SAP AG HR325 10-32

Event group feature Employee
Benefit event group

Evtg. Text
FULL Full time EEs
OTHR All other EEs
... Benefit
Benefit
area
area
Employee
Employee Employee
Employee
group
group group
group
Employment Employment Employment

Union
Union contract contract contract
A
A B
B FULL
FULL OTHR
OTHR ...
... ...
...
R
...
...
SAP AG
The event group feature's technical name is EVTGR.

The event group feature enables you to group employees according to their personal data.
The for every event group and every defined event, you later specify a set of event permissions.
This means that for different groups of employees who might, for example, experience the event New
child', you can specify different event permissions.
(C) SAP AG HR325 10-33

Define Adjustment Grouping & Set Up Feature
Benefits Adjustment Grouping

Adjustment grouping Text
OTHR All other employees
Feature
Process feature EVTGR: decision tree

EVTGR EVTGR Adjustment grouping
BAREA Benefit area
After defining an adjustment 99 Internation. Basic
grouping, you must set up WOSTD ? 20Hours per week compared with 20
the EVTGR feature.
< (smaller)
OTHR
otherwise
FULL
SAP AG 1999

In this example, the feature is making decisions on benefit area (BAREA) and hours per week
(WOSTD).
The adjustment groupings being assigned here are FULL and OTHR.
(C) SAP AG HR325 10-34

Adjustment Permissions
FULL
Adjustment
Adjustment
PART
grouping
grouping
Adjustment
Adjustment
TEMP permissions
permissions
Display IMG
Adjustment
Adjustment ORGC Benefits Administration
Basic Settings
reason
reason CHILD Plans
MEDI DENT Flexible Administration
Plan
Plan type
type Prerequisites and corequisites
Programs
Standard selections
Benefits adjustment reasons
Define ben. adj. groupings
Define ben. adj. reasons
Define adjustment permissions
Health plans
Insurance plans
...
Overview of adj. permissions
SAP AG 1999
The dark box represents a set of adjustment permissions applicable to employees who:
- are in adjustment grouping FULL
- have had a new child
- want to change a plan under plan type Medical Plan
(C) SAP AG HR325 10-35

Define Adjustment Permissions
Adjust. reason CHIL New child born
Adj. grouping FULL Full time employees
Plan type MEDI Medical Depending

Depending on on the
the plan
plan category,
category,
Change Add Delete
the
the relevant
relevant plan
plan building
building blocks
blocks
Benefit plan
and
and fields
fields appear
appear onon the
the screen
screen
and
and are ready for input or not.
are ready for input or not.
Change Increase Decrease
Option
Dependent cov. Adjust. reason CHIL New child born
Dependents FULL Full time employees

Adj. grouping
Pre-tax ind.
Plan type LIFE Life Insurance
Change Add Delete
Benefit plan
Change Increase Decrease
Insur. option
Addtl. units
Beneficiaries
Pre-tax ind.
SAP AG 1999
The permissions can be defined for each combination of adjustment reason, adjustment grouping and
plan type.
Depending on the plan category, the following permissions are possible:
y Substitute current plan with a plan of this plan type
y Enroll in a plan
y Terminate participation in a plan
y Change
- plan option
- dependent coverage
- dependents/beneficiaries
- investments
- from pre-tax to post-tax contributions and vice versa
- the indicator for start post-tax immediately
y Decrease or increase
- pre-/post-tax contributions
- additional units
(C) SAP AG HR325 10-36

Administrative Parameters: Topic Objectives
z Explain what the following administrative

parameters do:
Open enrollment period
Infotype validity for
open enrollment
adjustment/standard plan processing
Years in advance
Age limits for dependents
Actual hours
SAP AG 1999
Define administrative parameters.
(C) SAP AG HR325 10-37

Administrative Parameters: Business Scenario
z Your companys open enrollment period is 1st to

30th of November.
z Employees are enrolled for the coming year, 1st
January to 31st December.
z Dependents may be enrolled up to the age
of 18, or 22 if a full-time student.
SAP AG 1999
(C) SAP AG HR325 10-38

Parameters for open and event offers
z Open enrollment:
regular period when employees
are allowed to select new benefit
plans.
z Event enrollment:
changes because of specific
changes in employees
circumstances.
z The system calculates an offer,
which lists the plans an employee
is eligible to enroll in.
SAP AG
Open offer
This is an offer of all benefits the employee is eligible for at open enrollment. The system automatically
calculates and presents the options, so that the employee can then make benefits choices.
Event offer
This can be identical to (in the case of a new hire) or a restricted version (as in a new baby) of the open
offer. In principle the event offer works the same way, except the choices the employee is given can be
restricted by permissions defined in the event customizing.
(C) SAP AG HR325 10-39

Administrative Parameters for Benefit Area
Benefit
Benefit area
area
Define
Define window
window
Is
Is there
there an
an open
open enrollment
enrollment period?
period? Yes of
of open
open
enrollment
enrollment
No Define
Define validity
validity Define
of Define validity
validity
of records
records of
created of records
records
created during
during created
adjustment/standard created during
during
adjustment/standard open
plan open enrollment
enrollment
plan processing
processing
Define
Define length
length of
of notice
notice
given
given for
for future
future plans
plans
Define
Define age
age limits
limits for
for
dependents
dependents
SAP AG 1999
If your company has no open enrollment period, you do not define any details for the open enrollment.
Open offer is an offer of all benefit plans the employee is eligible for at open enrollment. The systme
automatically calculates and presents the options, so that the employee can then make benefit plan
choices.
Adjustment offers can be identical to or a restricted version of the open offer. In principle, the
adjustment offer works the same way, except the choices the employee is given can be restricted by
permissions defined in the Adjustment reason section of the Benefits IMG.
Standard plans are default and automatic plans.
Automatic plans are those which employees are enrolled in, without the requirement that they consent or
make any elections within the plan.
Default plans are those which employees are temporarily enrolled in, before they have handed back in
their election choices. Default plans are useful for giving short-term coverage to new hires.
(C) SAP AG HR325 10-40

Flexible Administration: Unit Summary
You are now able to set up:

z Prerequisite and corequisite plans
z Administrative parameters
z Benefit programs
z Eligibility and termination rules
z Standard plans
z Adjustment reasons
z Forms
SAP AG 1999
(C) SAP AG HR325 10-41

COBRA (USA)
Contents:
z COBRA plans
z Qualifying events
z Event coverage periods
z Notification and payment intervals
z Processing parameters
z Early termination reasons
SAP AG 1999
(C) SAP AG HR325 11-1

COBRA: Unit Objectives
z Define COBRA plans.
z Define qualifying event coverage periods.

z Assign COBRA events to personnel actions.
z Define notification and payment intervals.

z Define processing parameters.
z Define early termination reasons.
z Describe how COBRA forms are set up.
SAP AG 1999
All the settings made in this topic, can be found in the Benefits IMG under COBRA.
(C) SAP AG HR325 11-2

COBRA: Course Overview Diagram (USA)
Basic
Concepts
Flexible
Stock Spending
Purchase Accounts
Plans (North
America)

Customizing
Tools
America)
SAP AG 1999
(C) SAP AG HR325 11-3

COBRA: Business Scenario
z By law, your company must offer continuation of

health benefits to employees who have
experienced a COBRA qualifying event.
z By law, your company must also
send a letter notifying the individual
of qualification for COBRA.
SAP AG 1999
(C) SAP AG HR325 11-4

COBRA Qualifying Event System Criteria
COBRA Master Data Record Current Health COBRA Setup

Qualifying Event in Selection Period Plan Records in IMG
Termination of Personnel action (0000) Termination +
employment e.g. termination reason death
Death of employee Personnel action (0000) Termination +
e.g. termination reason = death
Reduction in 1. Planned working time (0007) 1. Eligibility rule 2. Reduced
work hours reduction in hours or for existing health hours personnel
2. Personnel action (0000) plan - req. hours action (optional
e.g. reduction in hours above employee's setup)
Entitlement to Additional personal data (0077)
Medicare Medicare checkbox - change
from blank to checked
Divorce Family/related person (0021)
new subtype 10 divorced spouse,
subtype 1 delimited
Legal separation Legal separation (0021/0106)
Loss of Family/related person (0021/0106)
dependent status birthday of dependent: user defined
during qualifying event collection
Bankruptcy of Employment status 2 (Retiree)
employer on personnel action infotype record
SAP AG 1999
A COBRA qualifying event is legally pre-defined.

The system looks at the employee's master data records to establish if a COBRA qualifying event has
occurred.
The system looks for COBRA valid plans in which the employee is enrolled.
The system distinguishes between death of employee and termination of employment via the set-up of
COBRA qualifying event and reason in the IMG.
(C) SAP AG HR325 11-5

Assign COBRA Events to Personnel Actions
Change View COBRA Events / Personnel Action Assignment

Act. Name of action type ActR Name of reason for action Event type Text
10 Leaving 02 Notice of termination by ER 01 Termination of employment
10 Leaving 03 Dismissal 01 Termination of employment

10 Leaving 09 Death of employee 03 Death of employee
10 Leaving 20 Immediate termination 01 Termination of employment
30 Change in employ... 02 Full-time to part-time 01 Reduction in work hours
... ... ... ... ... ...
SAP AG 1999
Here, you define how the system recognizes COBRA-qualifying events from employee Personnel events
(Infotype 0000) records. In principle, you assign COBRA event types to Personnel events. The COBRA-
qualifying event types that you assign in the example shown above are:
y Termination
y Death of employee
y Reduction in work hours
(C) SAP AG HR325 11-6

Choose COBRA Plans
Change View Benefit Plan COBRA Relevancy

Plan Extension period Start date End date COBRA applicability
DENT Standard Dental Plan 07.04.1986 31.12.9999
MED1 Medical Plan 1 07.04.1986 31.12.9999
MED2 Medical Plan 2 07.04.1986 31.12.9999
MEDS Medical for Singles 07.04.1986 31.12.9999
SDNT Suppl. Dental Plan 07.04.1986 31.12.9999
VISI Vision Plan 07.04.1986 31.12.9999
SAP AG 1999
In this step, you select those health plans that you have already defined in the system, that are COBRA-
relevant.
This means that when a Human Resources Representative collects COBRA Qualified Beneficiaries, the
system will only consider employee enrollments in the plans you select here, as legitimate cases where
COBRA must be offered to the employee.
Only the plans selected here will be available for election in the COBRA offer.
(C) SAP AG HR325 11-7

Define Qualifying Event Coverage Periods
Change View COBRA Maximum Coverage Period

Type Event type Start date End date Period Extension period
01 Termination of employment 07.04.1986 31.12.9999 18 11
02 Reduction in work hours 07.04.1986 31.12.9999 18 11
03 Death of employee 07.04.1986 31.12.9999 36

04 Entitlement to Medicare 07.04.1986 31.12.9999 36
05 Divorce 07.04.1986 31.12.9999 36
06 Legal separation 07.04.1986 31.12.9999 36
07 Loss of dependent status 07.04.1986 31.12.9999 36
08 Bankruptcy of employer 07.04.1986 31.12.9999 36
... ... ... ... ...
SAP AG 1999
Here, you define the events which qualify an individual for COBRA enrollment and the period of
permitted coverage depending on the qualifying event type.
There are 8 legally defined qualifying event types. The SAP standard system contains those 8 standard
qualifying event types and the legally required minimum coverage for each. You are responsible for
maintaining these entries.
The regular 18-month continuation coverage period can be extended for up to 11 months if a qualified
beneficiary is determined disabled under the Social Security Act at any time during the first 60 days of
COBRA coverage. The 11-month extension is available to all individuals who are qualified beneficiaries
due to the COBRA qualifying event. The disabled individual can be a covered employee or any other
qualified beneficiary.
(C) SAP AG HR325 11-8

Define Notification and Payment Intervals
State Description Start date End date

CA California 07.04.1986 31.12.9999
DC District of Columbia 07.04.1986 31.12.9999
Change View COBRA Administrative Data
Start End
State DC District of Columbia 07.04.1986 31.12.9999
Notification periods Payments
Election period 60 Days Payment grace period 45 Days

Employer 30 Days Monthly payments 30 Days
Administration 14 Days Payment due date 0 of month
Beneficiary 60 Days
Notification of disability Fees
Disability 60 Days
Regular period 102 %
End of disability 30 Days
Disability extension 150 %
SAP AG 1999
This information can be defined for each US state, since state law regarding COBRA may vary.
The entry for DC is delivered in the standard and is also the default entry for states not defined here.
(C) SAP AG HR325 11-9

Define Processing Parameters
Change View Benefit area COBRA processing parameter
Benefit area 99 Internation. Basic
For COBRA-relevant event types
End of employment
Work reduction
Death of employee
Medicare
Divorce
Legal separation
Loss depend. status
ER bankruptcy Cutoff date bankrupt
Other data - COBRA Administration
Residence status that excludes COBRA A
Start COBRA when loss of coverage
SAP AG 1999
Here, you define the COBRA qualifying event that you want to collect on a regular basis. Typically a
Human Resources Representative will collect all COBRA qualified beneficiaries, who have experienced
any COBRA event except Bankruptcy of employer.
You can also define a residence status of individuals who are not eligible for COBRA. These individuals
must have a Residence status (Infotype 0094) record, of the type defined here in this view.
You define when the COBRA eligibility period starts. This can start once the event has occurred, or once
regular coverage has stopped. The COBRA event date and the end date of the regular health plan can
differ if the termination rule associated with the health plan allows for continuation of regular coverage
beyond the COBRA event date (e.g. until the end of the current month).
(C) SAP AG HR325 11-10

Define Early Termination Reasons
Change View COBRA Early Termination Reason

Reason Text
01 Dependent makes no payment
02 Obtained other coverage
COBRA Qualified Beneficiary (Infotype 0211)
Personal data
Beneficiary
Type of person
SSN D.o.birth
Participation data Administrative date
COBRA status BenArea

Reason Dependent makes no payment 1stProGrp
Obtained other coverage
Reply date 2ndProGrp
State
Event data
Event type
Event occured 2nd event
Notification
SAP AG 1999
Early termination reasons can be stored in the COBRA infotype (0211).

This is to record why enrollment in COBRA was terminated, if this was before the normal coverage
period was over.
(C) SAP AG HR325 11-11

COBRA: Unit Summary

z Define COBRA plans.
z Define qualifying event coverage periods.

z Assign COBRA events to personnel
actions.
z Define notification and payment intervals.
z Define processing parameters.
z Define early termination reasons.

z Describe how COBRA forms are set up.
SAP AG 1999
(C) SAP AG HR325 11-12

Benefits Processing
Contents:
z Enrollment
z Eligibility
z Insurability
z Termination
z Benefits ESS Scenarios
z Data transfer to provider
z Benefits payments report
SAP AG 1999
(C) SAP AG HR325 12-1

Benefits Processing: Unit Objectives
z Enroll employees in benefit plans.

z Monitor employee eligibility.
z Process evidence of insurability
(EOI).
z Terminate employee enrollments.
z Describe the Benefits ESS scenarios.
z Describe the data transfer to
providers.
z Describe the benefits payments
report.
SAP AG 1999
(C) SAP AG HR325 12-2

Benefits Processing: Course Overview Diagram
Basic
Concepts
Flexible
Stock Spending
Purchase Accounts
Plans (North
America)

Customizing
Tools
America)
SAP AG 1999
(C) SAP AG HR325 12-3

Benefits Processing: Business Scenario
z A new employee is hired and must be enrolled in a

health plan.
z You need to verify the employee is still eligible for
his/her current benefit plans.
z You need to record EOI in the system.
z You need to terminate an employees participation
in a benefit plan.
SAP AG 1999
(C) SAP AG HR325 12-4

Enrollment II
System
... checks
Plan dialog box
EOI
EOI
Maintain Health Plan
Pre
Pre &
& corequisites
corequisites
Combined
Election of plan option, dependents, etc.

Pers.no. 4401 Miss Rose Salizar
Combined
Plan Medical for Singles
contributions
contributions
From 01.01.2000 - 31.12.2000
Combined
Combined
coverages
coverages
Stop participation in period
...
...
Double-
Option
click on
plan you
Employee
wish to Plan options
enrolled in plans
enroll in Option Special Option
Credit plan
Dependent cov. Employee only (Infotype 0236)
Insurance plan
Costs UNI Semi-monthly (Infotype 0168)
Employee 541.67 Deducs.pre-tax Health plan
Employer 108.33 (Infotype 0167)
Plan option
Accept
Dependents
Costs
SAP AG 1999
From the plan list, you choose one or several plans you want to enroll your employee in. For each plan,
you receive a plan dialog box, where you make elections like plan option, costs, dependents etc.
The system carries out different checks and creates the corresponding infotypes.
In the case of an adjustment offer, the system checks that the employee has a valid Adjustment reason
record (infotype 0378) and creates a unique adjustment offer, for every employee according to their
eligibility and the adjustment permissions.
Under Benefits Group enrollment, you can enroll a group of employees in automatic and default
plans.
(C) SAP AG HR325 12-5

Open offer processing
Benefits
Current benefits Open offer Event offer Eligibility Insurability
Open offer created - System Employee

all changes permitted checks enrolled in plans
General ben. data Credit plan
(Infotype 0171) EOI,
EOI, (Infotype 0236)
Pre
Pre && corequisites,
corequisites, Insurance plan
Combined
Combined
Open
Open Enrollment
Enrollment contributions (Infotype 0168)
period contributions and
and
period coverages. Health plan
coverages.
(Infotype 0167)
Plan option
Dependents
Costs
SAP AG
The Open offer button allows you to enroll employees during your company's open enrollment period.
The system checks that processing is taking place in the open enrollment period, and creates a unique
open offer for every employee, according to their eligibility.
The system carries out its normal checks and enrolls employees according to their benefits choices.
(C) SAP AG HR325 12-6

Eligibility
Benefits
Enrollment
Termination
Eligibility System Plans listed for Employee
checks which employee enrollments
no longer eligible terminated
and reasons for
Credit plan ineligibility
(Infotype 0236)
Eligibility check Validity Reason for
Insurance plan
Benefit
Benefit area
area 8.9.99 ineligibility Credit plan
(Infotype 0168)
1st
1st program
program
(Infotype 0236)
Health plan grouping
grouping Health plan
(Infotype 0167)
2nd
2nd program
program (Infotype 0167)
grouping
grouping Plan option
Plan option
Dependents
Eligibility
Eligibility rule
rule Dependents
Costs
Corequisites
Corequisites Costs

...
...
SAP AG 1999
The Eligibility Monitor allows you to find employees that are no longer eligible for the plans they are
participating in.
The system checks that the employee's plan is in the program defined for her benefit area/first and
second program grouping combination, stored on her General Benefits Data (infotype 0171) record.
Then the system checks that the employee fulfills the plan's eligibility rule and that the corequisite plan
requirements are fulfilled.
The system displays the reason for ineligibility for each plan an employee is no longer eligible for.
The default date for the termination of enrollments is the day before the date of processing, but you can
overwrite this date.
(C) SAP AG HR325 12-7

Insurability
Benefits
Enrollment
Termination Insurability proven Stop participation
Eligibility Status Option End of grace period Stop participation
Insurability Insurability on 08.09.1999
99 Internation. Basic or
4401 Rose Salizar
Medical Plan 2 Option 2 09.05.1999
Plans requiring EOI 4411 Chris Smith Provide EOI

Standard Life Ins. Coverage Level 1 Proven
Medical Plan 2 Option 2 09.05.1999
Insurance plan 4412 Alan Miller
Insurance plan
(Infotype 0168) Altern. Life Ins. Coverage Level 2 01.12.1999 (Infotype 0168)
4413 Peter Banks
Health plan Stand. Life Ins. Coverage Level 1 01.08.1999 Health plan
(Infotype 0167) Altern. Life Ins. Coverage Level 2 01.10.1999 (Infotype 0167)
Plan option Plan option
Record is locked Dependents
Dependents Active
Costs Costs
Pending
Insurability proven
Grace period expired
Insurability not proven
x Statement required
x Statement required
x Insurability proven
Insurability proven
SAP AG 1999
For certain levels of plan coverage, employees are required to provide proof of their insurability. This is
usually done in the form of a document called Evidence of Insurability (EOI).
The EOI Monitor allows you to keep track of employees who have not yet provided this evidence to the
employer.
You can confirm that EOI has been provided and if necessary activate pending enrollments.
You can further manage EOI by terminating employee enrollment, when the employee has not provided
EIO within the grace period.
(C) SAP AG HR325 12-8

Termination
Benefits
Enrollment Plans listed in which
Termination the employee is
participating
Termination for 01.10.1999 - 27.12.1999 Employee
participation
4401 Rose Salizar on 08.09.1999
terminated
Savings plan
Valid from Action
(Infotype 0169)
Dental Savings plan
Insurance plan Standard Dental Plan 01.01.2000-31.12.2000 Terminate on 08.09.1999 (Infotype 0169)
(Infotype 0168) Medical
Medical Plan 1 Plan 01.01.2000-31.12.2000 Terminate on 30.12.2000
Health plan
Health plan Life Insurance (Infotype 0167)
(Infotype 0167) Standard Life Insurance 01.01.2000-31.12.2000 Terminate on 31.01.2000 Plan option
Plan option Savings
Dependents
Standard Savings Plan 01.01.2000-31.12.2000 Terminate on 08.09.1999
Dependents Costs
Costs
Change Selection Date
Selection date 31.05.2000 Default termination date

can be overwritten
SAP AG 1999
Participations are selected according to employee and you can terminate individual participations or
many for groups of employees.
The default termination date is the date defined by the termination rule for the plan. This date can also be
overwritten.
(C) SAP AG HR325 12-9

Benefits Processing: Unit Summary
You are now able to :

z Enroll employees in benefit plans.
z Monitor employee eligibility.
z Process evidence of insurability (EOI).
z Terminate employee enrollments.
z Describe the Benefits ESS Scenarios.
z Describe the data transfer to providers.
z Describe the benefits payments report.
SAP AG 1999
(C) SAP AG HR325 12-10

Benefits Processing (North America)
Contents:
z FSA processing (North America)
z COBRA processing (USA)
SAP AG 1999
(C) SAP AG HR325 13-1

Benefits Processing (North America): Unit Objectives
z Enroll an employee in a Flexible Spending

Account (FSA).
z Enter an FSA claim.
z Terminate an employee and collect

the COBRA event.
SAP AG 1999
(C) SAP AG HR325 13-2

Benefits Processing (North America):
Basic
Concepts
Flexible
Stock Spending
Purchase Accounts
Plans (North
America)

Customizing
Tools
America)
SAP AG 1999
(C) SAP AG HR325 13-3

Benefits Processing (NA): Business Scenario
z Some of your employees are enrolled in a

dependent care FSA. As claims are submitted,
you process them weekly, and then employees
are reimbursed through payroll in the next payroll
run for their payroll area.
z In order to ensure swift processing of COBRA
qualified beneficiaries, you collect COBRA
qualifying events on a weekly basis.
SAP AG 1999
(C) SAP AG HR325 13-4

Flexible Spending Accounts (North America)
z Process employee claims on money

saved in FSAs.
z Monitor the balance on the
accounts.
z Allow a grace period to submit
claims for expenses incurred in the
preceding year.
SAP AG 1999
The money set aside in an employee's Flexible Spending Account (FSA) must also be accessible for
costs that occur during the course of the year. The FSA component allows you to process the claims
employees make on the money saved in FSAs. You can monitor the balance on the account and also
allow a grace period during which employees are still allowed to submit claims for expenses incurred in
the preceding year.
Processing allows you to look at FSA plan enrollments and display the balance on the account.
(C) SAP AG HR325 13-5

FSA Claims Processing I
Employee has Employee FSA Claims Payment records

spending brings claim to record created can be accessed
account benefits office by payroll
Flexible Spending
FSA Claims
Account
(Infotype 0172)
(Infotype 0170)
Annual Claim amount Payroll
Payroll
contribution Receipt type
Validity dates
Receipt
Receipt
SAP AG 1999
You find this function in the Benefits menu under Benefits Administration Flexible spending
account claims.
Within FSA claims processing, you can do the following;
- Display and change the employee contribution (Infotype 0170)
- Enter a claim (Infotype 0172)
- Cancel a claim
- Register an employee's agreement
- Display the balance on the employee's account.
The payroll then processes this information.
(C) SAP AG HR325 13-6

FSA Claims Processing II
Create Spending Account Claims

Personnel no
4401
Name Rose Salizar
...
Plan type Dependent Care
Benefit plan Dependent Care Spending Acct
Claim data
Claim date 15.12.1999 Cancellation
Date cost incurred 09.12.1999 Claim cancelled
Claim 300.00 UNI Agreement to cancellation
Claim on hold
Receipt type Daycare
Receipt number 1
SAP AG 1999
This is where the FSA claim (infotype 0172) is entered.

The Claim date is the date on which the employee submits the claim to the Benefits office.
The Date cost incurred is the date the cost was incurred. This is often the date on the receipt.
The Claim on hold flag shows whether a claim has the status pending, e.g. if an employees claim
needs further investigation before it can be accepted and processed.
(C) SAP AG HR325 13-7

COBRA Administration I
z Qualifying event collection

z COBRA letter generation
z Participation
z Payments
z Cost summary
z Election period monitor
...the company offers you three plans

for the continuation of your health
coverage after termination...
SAP AG 1999
COBRA processing consists of four clearly demarcated areas:

- Event collection
- Letter generation
- Participation in COBRA health plans
- Registering of payments
Now you can modify COBRA notices and even replace the SAP Standard COBRA letter generation with
a user exit. The user exit (PCOB0001 - COBRA letter) enables you to enter your own code to manage
your unique COBRA letters. You can generate correspondence for new COBRA events only or for all
COBRA events.
(C) SAP AG HR325 13-8

COBRA Administration II
... COBRA
Collect events
Create letters
Participation
Payments
Cost summary
Qualifying
Qualifying Election period monitor
event
event ...
occurs
occurs
... Create
Create Infotype
Infotype
COBRA
Family/related person (Infotype 0211)
(Infotype 0021) Qualifying event Event Data
Events collection COBRA data
(Infotype 0000)
Personnel event
Print
Print COBRA
COBRA letter
letter
Status
Organizational
assignment
SAP AG 1999
COBRA qualifying events may occur, which cause employees to lose group health care coverage.
The system identifies the employees who have experienced COBRA qualifying events.
You can print COBRA letters which consist of a notice of continuation rights, COBRA election and
COBRA enrollment forms, which can be sent out to the qualified beneficiaries concerned.
The system simultaneously and automatically creates a COBRA infotype record (0211) record for each
beneficiaries concerned.
While the system prints the COBRA letters, it also delimits existing health plans, according to the
termination variant associated with the plan in the benefit program.
In addition, the system transfers the possible dependents of each COBRA qualified beneficiary from
infotpye 0021 to the COBRA Dependent of Qualified Beneficiary table. Later on, it is possible to add
persons to the list of COBRA dependents (e.g. new spouse of an employees former spouse).
(C) SAP AG HR325 13-9

COBRA Administration III
... COBRA
Collect events
Create letters
Participation
Payments
Cost summary
Election period monitor
Forms
Enrollment
Confirmation
Invoice Register COBRA
payments
Qualified beneficiary
in the system COBRA Payments
(Infotype 0270)
COBRA Qualified
Beneficiary Enroll in
COBRA Beneficiary
(Infotype 0211)
Payment amount,
Event Data date and method
COBRA Health
COBRA data Plan (Infotype 0212)
Plan Data
Costs
IT 0211 updated
SAP AG 1999
The Participation function allows you to enroll COBRA qualified beneficiaries and their dependents in
COBRA plans. You can also:
- Delimit COBRA health plans upon early termination of COBRA coverage.
- Display qualified beneficiaries current election of COBRA health plans.
- Update the COBRA Qualified Beneficiary infotype (0211) with this new information.
The Payments function allows you to manually record COBRA payments in the system (infotype 0270)
as they come into the benefits office.
The Election period monitor displays a list of COBRA qualified beneficiaries whose election period
have expired.
Here you can reject these individuals, because they have forfeited their COBRA rights.
Under Forms, you can print out enrollment, confirmation and invoice forms.
(C) SAP AG HR325 13-10

COBRA Administration Menu
COBRA Administration
Events Letter generation Participation Payments
Qualifying
Qualifying
Event
Event
occurs
occurs
... Create
CreateInfotype
Infotype
COBRA
(Infotype 0021) Register COBRA
Event Event Data payments
Events Collection
(Infotype 0000)
COBRA data
COBRA Payments
Personnel event (Infotype 0270)
Print
Print letters
lettersand
andforms
forms Enroll in
Status COBRA Beneficiary
Organizational
assignment COBRA Health Payment amount,
Plan (Infotype 0212) date and method
Plan Data
Costs
R
SAP AG
The COBRA menu logically takes you through the four steps of COBRA processing:
Events:
y Identifies COBRA qualified beneficiaries.
Letter generation:
y Prints letters of notification, COBRA election and COBRA enrollment forms.
y Delimits existing health plan records (Infotypes 0167).
y Automatically creates COBRA qualified beneficiary (Infotype 0211) records
Participation :
y Enrolls COBRA qualified beneficiaries in COBRA health plans (Infotype 0211)
y Updates the COBRA qualified beneficiary (Infotype 0211) with this new information
Payments:
y Allows manual creation of COBRA payments (Infotype 0270) records
(C) SAP AG HR325 13-11

Benefits Processing (NA): Unit Summary

z Enroll an employee in an FSA.
z Enter an FSA claim.

z Terminate an employee and collect
the COBRA event.
SAP AG 1999
(C) SAP AG HR325 13-12

Reporting & Customizing Tools
Contents:
z Benefit reports
z Customizing tools
z User exits
z Benefits queries in the Business Information
Warehouse
SAP AG 1999
(C) SAP AG HR325 14-1

Reporting & Customizing Tools: Unit Objectives
z Run different kinds of reports to display

employee, participation and plan data as well as
statistics.
z Run the configuration consistency check and
describe the use of other Customizing tools.
z Describe why you might use a user exit.
z List the Benefits queries in the Business
Information Warehouse.
SAP AG 1999
(C) SAP AG HR325 14-2

Reporting & Customizing Tools:
Basic
Concepts
Flexible
Stock Spending
Purchase Accounts
Plans (North
America)

Customizing
Tools
America)
SAP AG 1999
(C) SAP AG HR325 14-3

Reporting & Customizing Tools:
Business Scenario
z Your company uses standard benefits reports to

track benefits costs and perform different kinds of
evaluations and the standard benefits tools to check
the configuration of the benefits system.
SAP AG 1999
(C) SAP AG HR325 14-4

Two types of Benefits reports
Credit plan Project: 325 Benefit Administration
(Infotype 0236)
+ Personnel management
Insurance plan
Benefits
(Infotype 0168) + Basic Settings
Health plan + Plans
(Infotype 0167) + Health Plans
+ Insurance Plans
Plan option + Savings Plans
+ Flexible Spending Accounts
Dependents + Credit Plans
+ Miscellaneous Plans
Costs Flexible Administration
+ Pre-requisites and co-requisites
+ Programs
Employee data + Standard Plans
+ Benefits Events
analysis + COBRA
+ Toolset
IMG analysis
SAP AG
There are two types of Benefits reports:

y Benefits IMG set up analysis reports, which are found in the toolset in the benefits IMG. These
reports analyze the customized settings for specific information, such as consistency of the set up,
cost of plans, overview of plans.
y Employee data analysis reports, which are accessed from the Benefits menu. The employee data
analysis reports are in the benefits menu. These reports analyze employee infotypes and produce lists
for example showing plan costs, vesting percentages, benefit change etc.
(C) SAP AG HR325 14-5

Employee data analysis reports
z Change of z Spending Premiums (USA)
General Benefits Data
z Health Premiums
z Participation
z Insurance Premiums
z Eligible Employees
z Savings Premiums
z Eligibility Change
z Miscellaneous Premiums
z Employee Demographics
z Vesting Percentage
z Benefit Change
SAP AG
The employee data analysis reports are found in the Benefits menu.
See the Benefits online help for more information. Search for Reporting.
(C) SAP AG HR325 14-6

Example: Insurance Plan Costs Report
Insurance Plan Costs
SAP AG 1999
The Insurance plan costs report (RPLBEN04) gives an overview of how much employee pays per pay
period for each insurance plan.
(C) SAP AG HR325 14-7

Plan Overview
Overview of benefit plans
By
By clicking
clicking on
on
the
the individual
individual
building
building blocks/
blocks/
attributes
attributes of
of the
the
plan,
plan, you
you can
can
directly
directly navigate
navigate
to
to the
the respective
respective
IMG
IMG view.
view.
Jump
Jump to
to feature
feature
structure.
structure.
SAP AG 1999
The Plan overview report (RPUBEN09) can be found in the Benefits IMG, under Toolset.
Plan overview report example: After setting up a benefit area for your company, you can use this report
to look at the complete setup of plans within it.
The system displays a tree, within which you can find all benefit plans that you selected. Where features
are used, you can jump to these from the tree. You can also navigate by clicking on parts of the tree to
display the implemented views.
(C) SAP AG HR325 14-8

Plan Cost Summary
Plan Cost Summary

99 (International)
SAP AG 1999
The Plan cost summary report (RPLBEN46) can be found in the Benefits IMG, under Toolset.
Plan cost summary report example: This report gives an overview of Health, Insurance and
Miscellaneous plans and their various options and how much the employee and employer pay in each
separate case.
After setting up a benefit area for your company, you can use this report to look at the costs of plans
within it.
(C) SAP AG HR325 14-9

Configuration Consistency Check
Benefit Configuration Consistency Check
SAP AG 1999
The Configuration consistency check report (RPUBEN42) can be found in the Benefits IMG, under
Toolset.
This report checks the consistency of the data in one benefit area, that you have entered in the benefits
Customizing steps. For example: If you have defined a benefit plan type, in view Benefit plan type, and
you have not defined any plans under this plan type in view Benefit plan, the report identifies the
inconsistency.
The report detects inconsistencies between only two views, not a set up concerning several. This gives
you a starting point for problem solving. For example, the report finds that an investment group is not
used by any savings plan. You decide the investment group is not needed and delete it. You run the
report again, and now find that there are investment options assigned to an investment group that no
longer exists. For this reason, it is important to be aware of the interdependency of the view entries.
You run the report from a graphic display which allows you to select the sections of the benefit area the
report will check.
- The report displays a list of errors in the benefit area setup.
(C) SAP AG HR325 14-10

Copy/Delete Benefit Area/Benefit Plan
z Copy benefit area/benefit plan

Copies all customizing entries related to a benefit area/
benefit plan
Benefit area X Benefit area Y
Plan X Plan Y
ZGR ZGR
Definition Definition
1 ZGR 1 ZGR
1 1
z Delete benefit area/benefit plan

Deletes all customizing entries related to a benefit area/
benefit plan
Benefit area Z
Plan Z
ZGR
Definition
1 ZGR
1
SAP AG 1999
The Copy benefit area report (RPUBEN43) copies a complete benefit area within a client. The report
copies all view entries under one benefit area and duplicates them under a new benefit area.
The Delete benefit area report (RPUBEN44) deletes complete benefit areas within a client. It deletes all
view entries under the benefit area you specify.
WARNING:
If you use this report, you are not just deleting the entry in the view Define benefit area, but all
customized entries for this benefit area. This means potentially entries in ALL views in the Benefits
IMG. Only start this report, if you are certain the benefit area you are about to delete is not required at
all.
The Copy benefit plan report (RPUBEN53) copies a benefit plan, complete with all Customizing entries
defined specifically for this plan. The report duplicates the plan under a new name.
The Delete benefit plan report (RPUBEN54) deletes complete benefit plans within a benefit area. It
deletes all view entries under the benefit plan you specify.
WARNING:
If you use this report, you are not just deleting the entry in the view Define general plan data, but all
customized entries for this benefit plan. Only start this report, if you are certain the benefit plan you are
about to delete is not required at all.
(C) SAP AG HR325 14-11

User Exits
Attention!
User Exit
WARNING! Use only if...

z The SAP standard processes do not suit your needs.
z You are a competent ABAP/4 programmer
SAP AG 1999
You can access the Benefits user exits in Benefits IMG, under Toolset.
WARNING: Employ user exits only if both of the following points apply:
- The SAP standard processes do not suit your needs.
- You are a competent ABAP/4 programmer.
From the IMG, you can implement benefits user exits.
All user exits are listed in the appendix of this training material.
If you need to implement any of these User exits, you first create a project for the user exit, then assign
the user exit(s) to your project. Then you write the coding for the user exit, and finally activate the
project.
For general information on user exits, in the SAP Library, go to Basis Components ABAP Workbench
BC - Changing the SAP Standard.
(C) SAP AG HR325 14-12

Reporting & Customizing Tools: Unit Summary

z Run different kinds of reports to
display employee, participation and
plan data as well as statistics.
z Run the configuration consistency
check and describe the use of other
Customizing tools.
z Describe why you might use a user exit.
z List the Benefits queries in the Business
Information Warehouse.
SAP AG 1999
(C) SAP AG HR325 14-13

Payroll Integration: Contents
z Providers
z Wage types
SAP AG
(C) SAP AG HR325 15-1

Payroll integration: Unit Objectives
At the conclusion of this unit,

you will be able to:
z Identify the places in benefits where
information is provided to payroll.
SAP AG
(C) SAP AG HR325 15-2

Course Diagram
Benefits Customizing Health Insurance Savings

Overview Benefits Plans plans plans
Credit Miscellaneous Benefits Reports

Administration
plans plans processing and tools
Benefits
integration
to Payroll
SAP AG
(C) SAP AG HR325 15-3

Payroll integration: Business Scenario
z Your company uses SAP R/3 Payroll, and
you must ensure that benefits information
is provided to the payroll.
SAP AG
(C) SAP AG HR325 15-4

Points of Integration to Payroll
z Benefit plan z Benefit providers
z Cost formulas z Contribution limits
z Credit formulas z Employee and employer

contributions
z Wage types
z Excess credit
z Plan status
SAP AG
The Payroll retrieves benefit related information from the Benefits administration module:
y Benefit plan - contains the wage type assignments which specify the employee contribution,
employer contribution and wage base.
y Cost and credit formulas - used to calculate premiums.
y Plan status - stores whether the plan is active, locked or closed.
y Benefits provider - is the creditor defined using vendor information from FI.
y Contribution limits used by savings plans.
y Employer matching - used by savings plans.
y Excess credit - information used to reimburse employee appropriately.
y Imputed income rates (USA only) used by group term life insurance plans.
(C) SAP AG HR325 15-5

Remittance to Benefit Providers
HR creditor 00000002 Blue Cross & Blue Shield

Number 0000000000000000002
Vendor VEND1
SAP AG
Vendor information is set up in FI and referenced within the Benefits IMG.
(C) SAP AG HR325 15-6

Wage Types - health plans
Benefit plan STMD STANDARD MEDICAL 01.01.1900 31.12.9999
General data
Type MEDI MEDICAL

Plan status OP OPEN
Wage types
EE contribution BE10 Medical deduction

ER post-tax deducs BE10 Medical deduction
ER contribution BR10 Medical contribution
Provider wage type BSAL Benefit-based salary
SAP AG
Wage types are set up in the payroll and simply selected from within the benefits configuration.
(C) SAP AG HR325 15-7

Wage Types - insurance plans
Benefit plan STLF STANDARD LIFE 01.01.1900 31.12.9999
General data
Type LIFE LIFE INS

Plan status OP OPEN
Wage types
EE contribution BE20 Life insurance deduction

ER post-tax deducs BE20 Life insurance deduction
ER contribution BR20 Life insurance contrib.
Provider wage type BR21 LTD insurance contr.
SAP AG
(C) SAP AG HR325 15-8

Wage Types - savings plans
Benefit plan STSV STANDARD SAVINGS 01.01.1900 31.12.9999
General data
Type SAVE SAVINGS

Plan status OP OPEN
Wage types
EE contribution BE30 Savings deduction

ER post-tax deducs BE30 Savings deduction
SAP AG
(C) SAP AG HR325 15-9

Wage Types - FSAs (USA only)
Benefit plan DPSD DEPENDENT CARE SPENDING ACCT 01.01.1900 31.12.9999
General data
Type DSPD DEPEND CARE

Plan status OP OPEN
Wage types
EE contribution BR41 Dependent care contrib.
SAP AG
(C) SAP AG HR325 15-10

Wage Types - credit plans
Benefit plan FLEX FLEXIBLE 01.01.1900 31.12.9999
General data
Type CRED CREDIT

Plan status OP OPEN
Wage types
ER contribution BR50 (ER) Flexible Credits

Calculation base BSAL Benefit-based salary
SAP AG
(C) SAP AG HR325 15-11

Wage Types - miscellaneous plans
Benefit plan CAR COMPANY CAR 01.01.1900 31.12.9999
General data
Type CAR COMPANY CAR

Plan status OP OPEN
Wage types
EE post-tax deducs BE30 Savings deduction
SAP AG
(C) SAP AG HR325 15-12

Payroll integration: Unit Summary
z The most important point of Benefits
integration to Payroll is in the wage type
views for each plan category.
SAP AG
(C) SAP AG HR325 15-13

R/3 System
Release 4.0
HR325
Exercises
Note: There may not be enough time to do all the exercises during
the course. The exercises are intended to be additional examples
that are dealt with during the course if required. Participants can
also use them to deepen their knowledge after the course.
(C) SAP AG HR325 16-1

Data to be Used
Benefit Area
Employee
Spouse
Child
Step-Child
Father
Mother
(C) SAP AG HR325 16-2

Unit: Customizing Benefits
At the conclusion of this exercise, you will be able to:

Organize a benefit program according to R/3 benefit category, type and
plan
You are planning the set up of your benefits plans and you need to
categorize them for configuration.
1-1 Non-system (paper) exercise: Assign the following list of your companys plans to the
benefits categories and types in the structure below. Two have already been done for
you.
ID Long Text
HMO Health Maintenance

Organization
DENT Standard Dental
LIF1 Basic Life
ACCS Access Savings
STSV Standard Savings
STLF Standard Life
ALIF Additional Life
401K 401K Savings Plan
FLEX Flexible Credit
CAR Company Car
CLUB Country Club membership
(C) SAP AG HR325 16-3

Fill in the structure below:
Health STMD Standard Medical
Insurance
Savings 401K 401K Savings
Credit
Miscellaneous
(C) SAP AG HR325 16-4

Now go to the IMG
1-2 Set current benefit area

Set the current benefit area. (Your benefit area will be assigned to you by your
instructor.) All the work you do as of now, will be done in your benefit area.
1-3 Define dependents and beneficiaries (Assigned by instructor)

Using sub-types, define individuals as dependents and beneficiaries:
A spouse as a beneficiary and dependent.
A child as a beneficiary and dependent.
A step-child as a beneficiary and dependent.
A father as a beneficiary
A mother as a beneficiary
1-4 Define benefit plan types

You define the benefit plan types within the pre-defined benefit plan categories. When
you later define the plans themselves, you assign these to a type. Define the following
benefit plan types and enter the appropriate category:
Categories: A for medical, B for Insurance, C for Savings, D for Spending, and E for
Miscellaneous
Type Type name

MEDI Medical
DENT Dental
LIFE Life Insurance
SPLF Supp. Life
AD&D AD&D
SAVE Standard Saving
LTSV Long Term Save
DPSP Dep Spend Acc
HCSP Health Sp Acc
CAR Company Car
LEIS Leisure
CLUB Cntry Club Mem
CRED Credit
(C) SAP AG HR325 16-5

1-5 Define benefit plan status
Define the following statuses:
OP (Open ) for active status and enrollment (Active enrollment allowed,
contains participants)
CL (Closed) as inactive (Inactive - no enrollment, no-one participating)
LO (Locked) as active but no enrollment. (Locked no enrollment but can have
participants)
(C) SAP AG HR325 16-6

Unit: Health Plans

Set up a health plan that includes the following:
Options
Dependent coverages
Cost formulas
Evidence of Insurability (EOI)
You need to set up two health plans for your benefit area.
Standard Medical has two options: a deductible and a non-deductible.
Cost of the plan depends on which option the employee chooses and
whether family members are included in the plan. Also whether the
employee is salaried or hourly paid affects the cost of the plan
2-1 Define health plan general data

For Standard Medical, enter the following data:
Benefit plan SM## (## = group number) / Standard Medical
From/to 01.01.1900-31.12.9999
Type MEDI
Plan status OP
Provider Standard Life
Health plan attributes Dependent relevant, Credits, Pre-tax allowed and
post tax allowed
2-2 Define options for health plans

Enter the two options for the Standard Medical health plan.
NODT no deductible
YSDT deductible
2-3 Define dependent coverage options

Define the dependent coverage options as follows:
(C) SAP AG HR325 16-7

EE- Employee only, with 0 dependents allowed
EE1 -Employee plus one, with 1 dependent allowed
EEF -Employee plus family , with up to 20 dependents allowed
2-4 Define cost formulas

A cost formula is the means of determining the cost of a health plan. The cost of a plan
is defined in two steps. In the first step, you identify the cost formula name and the cost
criteria. In the second step, you define the cost itself in the cost formula calculation
rule.
Enter the six cost formulas for each combination of option and dependent coverage.
All cost formulas for Period 1 and Variable Selected.
DEE Deductible EE only
DEE1 Deductible EE plus one
DEEF Deductible EE plus family
NDEE No deductible EE only
NDE1 No deductible EE plus one
NDEF No deductible EE plus family
2-5 Define cost formula calculation rules

Use the same validity dates for all rules: 01.01.1900-31.12.9999
For each rule, make two cost groups (HRLY and SLRY), with total costs the same as
provider costs for both groups. Employer costs for the HRLY and SLRY cost groups
will differ as indicated below.
Rule: DEE - Deductible EE only

Total and provider costs for both groups: $200
Employer costs
HRLY $175, SLRY $190
Rule: DEE1 - Deductible EE plus one

Employer costs
Rule: DEEF - Deductible EE plus family
Employer costs
(C) SAP AG HR325 16-8
Rule: NDEE No Deductible EE only
Employer costs
Rule: NDE1 No Deductible EE plus one
Employer costs
Rule: NDEF No Deductible EE plus family
Employer costs
2-6 Assign health plan attributes

Assign all the attributes for health plans, by assigning options and dependent coverage
choices to cost formulas, all with validity date 01.01.1900-31.12.9999.
Option Dependent coverage Formula
YSDT EE DEE
YSDT EE1 DEE1
YSDT EEF DEEF
NODT EE NDEE
NODT EE1 NDE1
NODT EEF NDEF
2-7 Define additional documents for health.

Define health plan SMxx as requiring Evidence of Insurability(EOI). All options
(YSDT and NODT) require it upon initial enrollment in the plan. The action the system
should take is create a pending record for the desired option, and allow a grace period
of 1 month from enrollment date.
2-8 Assign wage types
(C) SAP AG HR325 16-9

BE10 to EE pre-tax contribution
BE10 to EE posttax contribution
BR10 to ER contribution
BSAL to Provider cost
2-9 Now set up the second health plan in your benefit area.
Standard Dental has only one option. Cost of the plan depends solely on whether the
employee is salaried or hourly paid
Define health plan general data

For Standard Dental, enter the following data:
Benefit plan SD## (## = group number) / Standard Dental
From/to 01.01.1900-31.12.9999
Type DENT
Plan status OP
Health plan attributes Dependent relevant, Credits, Pre-tax allowed and Post tax
allowed

Enter the option for the Standard Dental health plan.
Health plan options OPT1 Option 1

rule.
Enter the cost formula ALL (All costs) that will be used for all combinations of option
and dependent coverage as follows to the Standard Dental health plan. For Period 01
and Variable selected.
2-12 Define cost formula calculation rules with validity dates 01/01/1900-31/12/9999 for
two cost groups (HRLY and SLRY) with total costs ($100) the same as provider costs
for both groups
Employer costs for the HRLY and SLRY cost groups will differ as indicated below
Employer costs: HRLY $90, SLRY $80
(C) SAP AG HR325 16-10
Assign attributes to the Standard Dental health plan for the options and dependent
coverage choices. All with validity dates 01.01.1900-31.12.9999 and formula ALL.
There is only one option (OPT1) with three different dependent coverage choices:
EE
EE1
EEF
2-14 Assign wage types.

Assign wage types to benefit plan SD##.
Assign wage type BE11 to EE pre-tax contribution and EE posttax contribution.
Assign wage type BR11 to ER contribution.
Assign wage type BSAL to Provider Cost.
(C) SAP AG HR325 16-11

Unit: Insurance plans

Set up an insurance plan to include the following:
Coverage and cost formulas
EOI
Set up two insurance plans for your benefit area.

Basic Life has two flat coverage options, however the actual amount of
coverage differs depending on the employee's personnel group. Cost of
the plan depends on the employee's personnel group and age.
The plan is considered imputed income and the employee can pay for it
using credit allocated in a credit plan.
3-1 Define insurance plan general data

For Basic Life, enter the following data:
Benefit plan BL## (## = group number) / Basic Life
From/to 01.01.1900-31.12.9999
Type LIFE
Plan status OP
Provider Legal and General
Insurance plan attributes Beneficiaries and Contingency beneficiaries relevant.
Pre and post tax premium payments are allowed.
Credit and imputed income relevant.
Group Term 1 (Employee Group Term)
3-2 Define coverage formula

Enter the two coverage formulas for Basic Life: LEV1 (Level One) and LEV2 (Level
Two), indicating coverage for both.
3-3 Define coverage formula calculation rules

Define the four coverage formula calculation rules as follows. Use validity dates
01.01.1900-31.12.9999.
(C) SAP AG HR325 16-12

Use Coverage Formula LEV1 for Coverage Group COG1 with Salary factor: 1 and
Coverage Group COG2 with Salary factor: 2.
Use Coverage Formula LEV2 for Coverage Group COG1 with Amount: $80,000 and
Coverage Group COG2 with Salary factor: 3.
A cost formula is the means of determining the cost of an insurance plan. The cost of a
plan is defined in two steps. In the first step, you identify the cost formula name and
the cost criteria. In the second step, you define the cost itself in the cost formula
calculation rule.
In the Basic Life plan, cost is directly proportional to how much coverage the
employee chooses. Thus only one cost formula is required.
3-4 Define criteria identifiers

Define criteria ID in the basic settings for the employee group US (Universal):
3-5 Define age groups

Define age groups in the basic settings for the employee groups.
An age group is associated with a criteria identifier. The age group defines a specific
age span by associating high and low values with an age group.
Define <35 (Less than 35 years) and >35 (More than 35 years)

Define cost formulas for the Basic Life Insurance plan
Define Cost Formula ALL (All) for a Monthly period usiong the US criteris ID and
select Age and Variable indicators.

Define the four cost formula calculation rules for the cost formula ALL as follows:
All groups have the same Base Unit amount ($1000) and validity dates (01.01.1900-
31.12.9999). Cost factors for Total and Provider costs will be the same within each
age group.
For Age Group <35
Cost Group HRLY, Total/Provider costs cost factor is $0.25
Cost Group SLRY, Total/Provider costs cost factor is $0.25
For Age Group >35
3-8 Assign insurance plan attributes
(C) SAP AG HR325 16-13

Assign the attributes for Basic Life, by defining two options and assigning the cost and
coverage formulas you have already defined. Use Validity dates 01.01.1900-
31.12.9999 and Cost Formula ALL for both.
Option 1 use Coverage Formula LEV1
Option 2 use Coverage FormulaLEV2

Assign the wage types to Basic Life as follows:
Assign Wage Type BE20 to EE contribution and EE posttax contribution
Assign Wage Type BR20 to Provider wage type
Assign Wage Type BSAL to Calculation base
Now set up the second insurance plan in your benefit area.
Additional Life has only one option, however the actual amount of coverage differs
depending on the employee's personnel group (salaried or hourly paid). Cost of the
plan also depends on whether the employee is salaried or hourly paid.

For Additional Life, enter the following data:
Benefit plan AL## (## = group number) / Additional Life
From/to 01.01.1900-31.12.9999
Type SPLF
Plan status OP
Provider Prudential
Insurance plan attributes Beneficiaries and Contingency beneficiaries are
relevant.. Pre and post tax premium payments are
allowed. Credit and imputed income are relevant.
Enter the coverage formula for Additional Life. With the coverage formula ALL (all
coverages) as a coverage group.

Define the two coverage formula calculation rules as follows. Both use Coverage
Formula ALL:
(C) SAP AG HR325 16-14
Coverage group COG1 uses Basis amount $10,000, with additional coverage unit
$1,000 and 90 maximum units.
Coverage group COG2 uses Basis amount $25,000, with additional coverage unit
$5,000 and 20 maximum units.
calculation rule. In the Additional Life plan, cost is directly proportional to how much
coverage the employee chooses. Thus only one cost formula is required.

Enter the cost formula ALL (All) for the Additional Life insurance plan, with a
monthly period and Variable selected.

Define the cost formula calculation rules for the cost formula ALL as follows:
Define the two cost formula calculation rules for cost groups HRLY and SLRY for the
cost formula ALL as follows:
Both groups have the same Base Unit amount ($1000) and validity dates (01.01.1900-
31.12.9999). Cost factors for Total and Provider costs will be the same within each
cost group.

Assign the attributes for Additional Life, by defining the one option (Option 1) and
assigning the cost (ALL) and coverage (ALL) formulas you have already defined for
the validity dates 01.01.1900-31.12.9999.
3-16 Define additional documents for Insurance

Define this plan as requiring Evidence of Insurability(EOI) upon initial enrollment in
the plan, an increase of $25,000 or more, or when a total of $100,000 coverage or more
is chosen. The action the system should take is create an active record for the desired
option, and allow a grace period of 1 month from enrollment date.
Benefit plan AL## (## = group number) / Additional Life
Initial enrollment $0.01
Change of coverage $24,999
Enrollment any time $100,000
(C) SAP AG HR325 16-15

Grace period 1 month from enrollment date
Validity dates 01.01.1900-31.12.9999

Assign the wage types to Additional Life as follows:
Assign Wage Type BE20 to EE contribution and EE posttax contribution
Assign Wage Type BR20 to Provider wage type
(C) SAP AG HR325 16-16

Unit: Savings Plans

Set up a savings plan to include the following:
Employee contributions for pre and post tax
Vesting rules
Investment options
Set up two savings plans for your benefit area.

In the Standard Savings, the employee may contribute pre-tax up to $500
and post tax up to $1000 per month. The plan is a guaranteed annuity
plan.
4-1 Define savings plan general data

For Standard Savings, enter the following data:
Benefit plan SS## (## = group number) / Standard Savings
From/to 01.01.1900-31.12.9999
Type SAVE
Plan status OP
Provider Merrill Lynch
Savings plan attributes Beneficiaries, Contingency beneficiaries and Investments
relevant.
Regulatory reports Non-deferred
4-2 Define employee contribution rules

Define employee contribution rules for the Standard savings plan.
Employee contribution rule: ALL
Description: All
Period: Monthly
(C) SAP AG HR325 16-17

4-3 Define employee contribution rule criteria
Define employee contribution rule criteria for the Standard savings plan for the ALL
employee contribution rule for validity dates 01.01.1900-31.12.9999
Select Amount and Pre-Tax. with a $100 minimum and a $500 maximum
Also select Post Tax. with a $100 minimum and a $1000 maximum
4-4 Define investments

Investments for savings plans are the options available to employees participating in
the benefit program. Investment options are available to savings plan participants.
Define the following investments for your savings plans:

ANNU: Guaranteed annuity
BLFD: Balanced fund
COMP: Company stock
4-5 Define investment groups

Investment groups are used to associate several investment options with a benefit plan.
A benefit plan then has an investment group consisting of several options.
SAV (Savings) and 401K (401K)
4-6 Assign investments to groups

Individual options are associated with investment groups:
For investment group SAV, investment ANNU and for investment group 401K,
investments BLFD and COMP.
4-7 Assign savings plan attributes

The attributes of the savings plan are assigned to the plan itself, as follows:
Benefit plan SS##
Employee contribution rule ALL
Investment group SAV
Validity dates 01.01.1900-31.12.9999

Assign the wage type to Standard Savings as follows:
Wage Type B30 for EE contribution and EE posttax deducs.
(C) SAP AG HR325 16-18

Now set up the second savings plan in your benefit area.
In the Standard 401K, employees may contribute pre-tax up to 15% and post-tax up to
10% of their income per month. The employer matches 10% up to different maximum
limits, depending on the length of service of the employee.

For Standard 401K, enter the following data:
Benefit plan S4## (## = group number) / Standard 401K
From/to 01.01.1900-31.12.9999
Type LTSV
Plan status OP
Provider Prudential
Savings plan attributes Beneficiaries, Contingency beneficiaries and
Investments relevant

Define employee contribution rules for the Standard 401k plan.
Description All
Period Monthly

Define employee contribution rule criteria for the Standard 401k plan for the ALL
employee contribution rule. Set validity dates 01.01.1900-31.12.9999.
Select Percent and Pre-Tax with a minimum of 1% and a maximum of 15%
Select Post-Tax with a minimum of 1% and a maximum of 10%.
Pre-tax contribution limit of $10,000.
4-12 Define employer contribution rules

For the Standard 401k plan, define employer contribution rule ALL with a monthly
period using the Universal criteria ID with Length of Service (LOS) indicated
4-13 Define length of service groups in the basic settings for the employee groups for the
Universal criteria ID. Create two LOS groups:
(C) SAP AG HR325 16-19

<10 (Less than 10 years) with the lowest value 1 and the maximum value 9, and >10
(More than 10 years) with the lowest value 10 and the maximum value 99
4-14 Define employer contribution rule criteria

Define employer contribution rule criteria for the Standard 401k plan for the ALL
employer contribution rule. Set Sequence number 1 and validity dates 01.01.1900-
31.12.9999 for both groupd.
For LOS group <10 set a 10% employee contribution with a limit of $10,000.
For LOS Group >10 set a 10% employee contribution with a limit of $15,000.
4-15 Define vesting rules.

A vesting rule defines a particular schedule. Define your vesting rule as:
5YR (5 Year Vesting)
4-16 Define vesting schedules

Define vesting schedules for the 5YR vesting rule.
20 percent after 1 Year
40 percent after 2 Years

The attributes of the 401k savings plan are assigned to the plan itself, as follows:
Benefit plan S4##
EE contr. Rule ALL
ER contr. Rule ALL
Vesting rule 5YR
Investment group 401K
Validity dates 01.01.1900-31.12.9999

Assign the wage types to Standard 401K as follows:
Wage type BE31 for EE contribution and EE posttax deducs.
(C) SAP AG HR325 16-20

Wage type BR31 for ER contribution.
Wage type BSAL for Calculation Base and Technical Base.
(C) SAP AG HR325 16-21

Unit: Flexible Spending Accounts (US only)

Set up an FSA to include:
employee contribution
Set up two FSAs for your benefit area.

In the Health Care FSA, the employee may contribute pre-tax up to
$10,000 annually.
5-1 Define FSA general data

For Health Care FSA enter the following data:
Benefit plan HF## (## = group number) / Health Care FSA
From/to 01.01.1900-31.12.9999
Type HCSP
Plan status OP
5-2 Assign spending account attributes

Enter the details of the Health Care FSA plan as follows:
Minimum amount $100
Maximum amount $10,000
Validity period 01.01.1900 31.12.9999
Benefit plan HF## (## = group number)
Reimbursement of claims wage types BE40
Minimum reimbursement amount $100
Previous year claim to 01 March
Maximum availability Annual contribution

Enter the wage type BR40 for the Health Care FSA plan: EE contribution
(C) SAP AG HR325 16-22
Now enter the details of the other FSA in your benefit area.
In the Dependent Care FSA, the employee may contribute pre-tax up to $15,000
annually.

For Dependent Care FSA enter the following data:
Benefit plan DF## (## = group number) / Dependent
Care FSA
From/to 01.01.1900-31.12.9999
Type DPSP
Plan status OP
Provider Prudential

Enter the details of Dependent Care FSA as follows:
Benefit plan DF## (## = group number)
Minimum amount $100
Reimbursement of claims wage types BE41
Minimum reimbursement amount $100
Validity period 01.01.1900 31.12.9999
Maximum availability Current account balance
5-6 Assign employee contribution wage types BR41 for the Dependent Care FSA plan.
5-7 Define FSA claim receipt types

Enter the receipt types: DAYC (Day care) and HOSP (Hospital visit)
(C) SAP AG HR325 16-23

Unit: Credit Plans

Set up a credit plan to include a credit formula and wage types.
Set up a credit plan for your benefit area.

In the Flexible Credit plan the employees receive an amount of credit,
depending on whether they are salaried or hourly paid employees. This
credit can then be used to pay for other benefit plans.
6-1 Define credit plan general data

For Flexible Credit, enter the following data:
Benefit plan FCXX (XX = group number) / Flexible Credit
From/to 01.01.1900-31.12.9999
Type CRED
Plan status OP
6-2 Define credit formulas

A credit formula is the means of determining the amount of money an employer will
distribute to employees in order to pay for their other benefit plans. The cost formula is
defined in two steps. In step one, you identify the credit formula name and the credit
criteria. In step two you specifically define the credit criteria.
Define the credit formula for Flexible Credit as follows:

Credit formula SIMP
Description Simple credits
Period Monthly
Select Credit group
6-3 Define credit formula calculation rules

Define credit formula calculation rules for the Flexible Credit plan for credit formula
SIMP with validity period 01.01.1900 31.12.9999
Set Rounding Rule A and Rounding Divisor 100 for both Credit Groups.
(C) SAP AG HR325 16-24

Credit Group HRLY with Credit factor 2.5, minimum amount $20 and maximum
amount $300.
Credit Group SLRY with Credit factor 5.0, minimum amount $50 and maximum
amount $500.
6-4 Assign credit plan attributes

Assign credit plan attributes for the flexible credit plan.
Validity dates 01.01.1900 31.12.9999
Credit formula SIMP
Excess % 50

Assign the wage types to Flexible Credit as follows:
Assign wage type BR50 to ER contribution, and wage type BSAL to Calculation base.
(C) SAP AG HR325 16-25

Unit: Miscellaneous Plans
At the conclusion of this exercise, you will be able to set up miscellaneous

plans to include
Cost formula
Cost formula calculation rules
Set up two miscellaneous plans for your benefit area.
The Company Car plan offers two types of car, luxury and sport.
Employees pay a higher premium if they live beyond a 20 mile radius of
the office.
7-1 Define miscellaneous plan general data

Benefit plan CC## (## = group number) / Company Car
From/to 01.01.1900 31.12.9999
Type CAR
Plan status OP
Plan attributes Cost/credits relevant
Cost formula
Post tax allowed
7-2 Define cost formula

For the Company Car define two cost formulas, both with monthly periods and
variable:
LUXY Luxury car
SPRT Sports car

Define the two cost formula calculation rules for each cost formula. All with the
validity period 01.01.1900 31.12.9999:
For cost Formula LUXY:
Cost Group FAR with a Total Cost of $330
Cost Group NEAR with a Total Cost of $300
(C) SAP AG HR325 16-26

For cost Formula SPRT:
Cost Group FAR with a Total Cost of $220
Cost Group NEAR with a Total Cost of $200
7-4 Assign miscellaneous plan attributes

Assign the attributes for Company Car for validity dates 01.01.1900 31.12.9999, by
defining options and assigning the cost formulas you have already defined:
For LUXY (Luxury car option), cost formula LUXY.
For SPRT (Sports car option), cost formula SPRT.

Assign the wage types to Company Car as follows:
Wage type BE30 for EE posttax deducs
Now set up the second miscellaneous plan in your benefit area.
The Health Club plan offers membership in the club for a flat monthly cost. The cost is the
same for all employees.

For Health Club, enter the following data:
Benefit plan HC## (## = group number) / Health Club
From/to 01.01.1900-31.12.9999
Type LEIS
Plan status OP
Cost formula selected
Post tax allowed

For the Health Club cost formula, define Cost Formula CLUB (Club Membership) with
a monthly period.:

Define the cost formula calculation rule for the health club plan and the CLUB cost
formula with validity dates 01.01.1900 31.12.9999 and total costs of $100.
(C) SAP AG HR325 16-27

Assign the attributes for Health Club, by defining the option CLUB and assigning the
cost formula you have already defined.

Assign the wage type BE30 to the Health Club plan: EE posttax deducs
(C) SAP AG HR325 16-28

Unit: Benefits Administration
At the conclusion of this exercise, you will be able to set up:

Pre-requisites and co-requisites
Benefit programs
Eligibility and termination rules
Standard plans
Benefit events
Benefit parameters
Set up the administration of the benefit plans you have defined for your
benefit area.
8-1 Define administrative parameters

For your administrative parameters, enter the following data:
Is an Open Enrollment period Yes
offered?
Open enrollment validity 01.11.19YY 30.11.19YY
(YY is current year)
Validity of records for open 01.01.19ZZ 31.12.19ZZ (
enrollment ZZ is current year +1)
Validity of records for 31.12.19YY (YY is current year)
event/standard plans
Maximum permitted age of Non student: 18
dependents Student: 21
No maximum age if physically
challenged
Prerequisite plans are those plans the employee must be enrolled in before it is possible
to enroll in another particular plan. An employee can enroll a particular plan and its
corequisite plans all at the same time.
(C) SAP AG HR325 16-29

8-2 Define prerequisite plans
For plan Additional Life (AL## ## is your group number), define the prerequisite
plan:
BL## Basic Life
8-3 Define corequisite plans

For plan Standard Dental (SD## ## is your group number), define the following
corequisite plan.:
SM## Standard Medical
Set up the benefit programs for your employees. First you define benefit groups and
employee statuses. Next you define eligibility and termination rules. Lastly for each
combination of benefit group and employee status, you define the program of plans for
which they are eligible, and attach the eligibility and termination rules to the plans.
8-4 Define employee benefit groups

Define the following employee benefit groups:
EXEC Executive employees
EXMT Exempt employees
HRLY Hourly employees
8-5 Define employee status

Define the following employee statuses:
PART Part time employees
TEMP Temporary employees
Now define the eligibility groups, rules and rule criteria.
8-6 Define eligibility groups

An eligibility group is a means of identifying groups of employees possessing common
characteristics relevant to the eligibility requirements of the benefits offered by your
organization. The eligibility group allows you to include supplementary eligibility
criteria that are not included in the standard eligibility criteria.
Define the following eligibility group: EGR1 (Eligibility group 1)
8-7 Define eligibility rules

Define the following eligibility rule: IMMD (Immediately eligible)
(C) SAP AG HR325 16-30

8-8 Define eligibility rule criteria
Define the following eligibility rule criteria for eligibility rule IMMD and eligibility
group EGR1 with
Validity dates 01.01.1900 31.12.9999
Enrollment Immediate
8-9 Define termination types
A termination type is a means of identifying types of employees possessing common

characteristics relevant to the termination requirements of your organization. The
termination type allows you to include supplementary criteria that are not included in
the standard termination criteria.
Define the following termination types:
TTYP Standard termination
8-10 Define termination rules

Define the following termination rules:
IMMD Immediate termination.
RUL1 Rule 1
RUL2 Rule 2
8-11 Define termination rule criteria

Define the following termination rule criteria for each combination of termination rule
and termination type. All have the validity dates 01.01.1900 31.12.9999 and
Termination Type TTYP.
For Termination Rule IMMD, no coverage continuation period (blank) for termination
immediately.
For Termination Rule RUL1, 4 months coverage continuation period for termination
on day31 or end of the month.
For Termination Rule RUL2, 1 month coverage continuation period for termination
immediately.
8-12 Define benefit programs

Define the benefit program for employees who fall into the benefit group EXMT and
the employee status FULL termination type. Eligibility ruke IMMD applies to all
plans.
Plan Description Termination rule
SM## Standard medical RUL1
(C) SAP AG HR325 16-31

SD## Standard Dental RUL1
BL## Basic Life RUL2
AL## Additional Life RUL2
SS## Standard Savings IMMD
S4## Standard 401K IMMD
FC## Flexible Credit IMMD
CC## Company Car IMMD
HC## Health Club IMMD
US only:
HF## Health Care FSA RUL1
DF## Dependent Care FSA RUL1
8-13 Define standard health plans

Define the following plans as default health plans, for EXMT and FULL employees,
both with dependent coverage.
For Plan Type MEDI, Plan SM##, set option NODT.
For Plan Type DENT, Plan SD##, set option OPT1.
8-14 Define standard insurance plans

Define the following plans as default insurance plans, for EXMP and FULL
employees:
Plan Type LIFE, Plan BL##, option OPT1, with no additional units.
A Benefit event is when an employee wants to make changes to enrollments due to a life or
organizational change. You can define the events and specify permissions for change in each
case. You can also define benefit event groups to allocate different permissions to different
groups of employees.
8-15 Define benefit event groups

Define the following benefit event group:
STRD Standard event group
8-16 Define benefit events
(C) SAP AG HR325 16-32

Define the benefit event CHIL New child:
Changes anytime, not allowed.
Total event process duration one month..
Start of records is the event date and end of records is the Default date (31.12.19YY
YY = current year)
Define the benefit event NRES No reason:

Changes anytime, allowed.
Total event process duration not defined..
Start of records is the event date (31.12.19YY YY = current year) and end of records
is the Default date (31.12.19YY YY = current year)
Define the benefit event INIT Initial enrollment:

Total event process duration six weeks. Event process duration after first choice six
weeks.
YY = current year)
Define the benefit event MARR Marriage:

Total event process duration two months. Event process duration after first choice one
month.
YY = current year)
Define the benefit event ORGC Organizational change:

Total event process duration six weeks. Event process duration after first choice not
allowed.
Start of records is the event date (31.12.19YY YY = current year) and end of records
is the Default date (31.12.19YY YY = current year)
Define the permitted changes for the health and savings plans in your benefit area.
(C) SAP AG HR325 16-33
8-17 Define permitted changes for events for Health plans
Go to -> Health plans. Define changes by plan type.
Event Event Plan type Selected

group
INIT STRD MEDI Create
INIT STRD DENT Create
CHIL STRD MEDI Change: option

dependent coverage
dependents
CHIL STRD DENT Change: option

dependent coverage
dependents
8-18 Define permitted changes for events for Insurance plans.

Go to -> Insurance plans
Event Event Plan Selected
group type
INIT STRD LIFE Create
CHIL STRD LIFE Change: option beneficiaries

Create: plan
CHIL STRD SPLF Change: option beneficiaries

Create: plan
8-19 Define permitted changes for events for Savings plans.

Go to -> Savings plans
group type
INIT STRD SAVE Create
INIT STRD LTSV Create
CHIL STRD SAVE Change: Beneficiaries

Increase: Pre-tax contribution and
Post-tax contribution
CHIL STRD LTSV Change: Beneficiaries
(C) SAP AG HR325 16-34

Increase: Pre-tax contribution and
8-20 Define permitted changes for events for Credit plans.

Go to -> Credit plans
group type
INIT STRD CRED Create
8-21 Define permitted changes for events for Miscellaneous plans.

Go to -> Miscellaneous plans
group type
INIT STRD CAR Create
INIT STRD LEIS Create
CHIL STRD CAR Change: option
CHIL STRD LEIS Change: plan

Create: plan
8-22 USA Only: Define permitted changes for events for Flexible Spending accounts.
Go to -> Flexible spending accounts

group type
INIT STRD DPSP Create
INIT STRD HCSP Create
CHIL STRD DPSP Change: benefit plan

Create: benefit plan
Delete: benefit plan
Increase: contribution
Decrease: contribution
CHIL STRD HCSP Change: benefit plan

Create: benefit plan
Delete: benefit plan
(C) SAP AG HR325 16-35

Increase: contribution
Decrease: contribution
(C) SAP AG HR325 16-36

Unit: COBRA (US Only)

Identify plans that are valid for COBRA
When US employees leave the company, they may be eligible to continue

their benefits under COBRA provisions. You need to flag plans valid for
COBRA.
Choose the plans valid for COBRA from those health plans you have already set up.
9-1 Choose COBRA plans

Select the SM## (Standard Medical plan as COBRA valid. But not the dental plan.
(C) SAP AG HR325 16-37

Unit: Benefits Processing

Enroll a newly hired employee in benefits plans
Hire an employee in Personnel Administration, then enroll the employee

in Benefits for benefit plans. Use the benefits event Initial enrollment to
enroll the employee. Then carry out EOI processing using the HR325
hiring action.
10-1 In Personnel Administration hire the employee

Personnel Action screen
Personnel number 325## (## is your group number)
From 01.01.19YY (YY is current year)
HR325 Hiring Selected
Enter the data for each infotype for the action HR325 Hiring as follows:
Actions (Infotype 0000)

Position Blank
Personnel area 3000
Employee group 1
Employee subgroup U4
Personal Data Infotype (0002)

Last name Your choice
First name Your choice
SSN Your choice
(C) SAP AG HR325 16-38

Birth date 03.04.1968
Gender Your choice
Marital status Marr

SSN Your choice
Organizational assignment (Infotype 0001)

Payroll subarea 0001
Payroll area US
Note: Select the Cancel icon on the Enter Position Assignment pop-up box
Address (Infotype 0006)

Address line 1 44## Oak Lane
City SAPBerg
State/zip code OH/44574
Select the Cancel icon in the Tax area pop-up box.

Select the Cancel icon in Residence Tax Area (Infotype 0207).
Planned Working Time (Infotype 0007)

Work Schedule Rule NORM
Basic pay (Infotype 0008)

Payscale group GRD01
Annual salary 30,000
Family/Related Person (Infotype 0021)
(C) SAP AG HR325 16-39

SSN Your choice
Gender Your choice
General benefits data (Infotype 0171)

Benefit area Override with your benefit area
Benefit group EXMT (default)
Employee status FULL (default)
Event: permissions (Infotype 0378)

Benefit event INIT Initial enrollment
Validity dates 01.01.19YY 12.02.19YY (YY is current

year)
10-2 In Benefits enroll the employee in benefit plans
In the Benefits screen

Choose the Event offer function.
In the Benefits - Main Program pop-up box enter the following:

Other period 01.01.19YY (YY is current year)
Choose Execute.
Click on the Enroll icon next to the line Initial enrollment.
In the Benefits offer screen select the following plans:
Plan Other data
Flexible credit None
Standard Dental Option 1

Employee only
Standard Medical With deductible

Employee only
(C) SAP AG HR325 16-40

Basic Life Option 2
Standard Savings Pre-tax contribution $100
Company Car Sports car option
Health Club None
Choose Enroll.
In the EOI pop-up box leave the checkbox blank to indicate that EOI had not yet been
provided by the employee.
Choose Enroll.
Choose Enroll again to confirm your enrollments.
Choose Enroll.
The employee is enrolled in the chosen benefit plans.
10-3 In Benefits process the employee's EOI.
You have just enrolled your employee in Standard Medical. However since EOI had
not at that time been provided, the system created the plan as pending only.
It is now two weeks later and the employee has just delivered the EOI to the benefits
office. You should now record this in the system.
In the Benefits Main Program

Choose the Insurability function.
In the Benefits - main program pop-up box enter the following:
Other date 15.01.19YY (YY is current year)
Choose Execute.
Select the plan Standard Medical and then the EOI provided function.
The employee's Standard Medical plan is now active and the record states that EOI has
been provided.
(C) SAP AG HR325 16-41

Unit: Processing (USA Only)
Topic: FSA Processing
Enroll an employee in an FSA.
Your company offers Flexible Spending Accounts,and you want to enroll
an employee.
11-1 In Benefits enroll the employee in an FSA benefit plan.

Benefits screen
Choose Execute.
Click on the enroll icon next to the line Initial enrollment.
Health Care FSA $1000 annual contribution
Dependent Care FSA $1000 annual contribution
Choose Enroll.
Choose Continue.
11-2 Process a check your employee has brought to the benefits office for processing.
Benefits screen
Choose the Administration -> Spending accounts claims.
And select Today.
Choose Execute.
(C) SAP AG HR325 16-42

Put your cursor on the Dependent Care spending account and select the
Claims icon.
In the pop-up box select Create.
In the FSA Claims (Infotype 0172) enter the following:
Benefit plan type DPSP
Claim submitted on Enter today's date
Date cost incurred Enter yesterday's date
Claim $100
Receipt type DAYC
Save your entries.
Return to the screen FSA: Administration and Balancing.
A claim now exists in the system and can be accessed by Payroll processing.
(C) SAP AG HR325 16-43

Topic: Cobra Processing

Terminate an employee and collect the COBRA event
Now terminate your employee's employment contract and collect this as a
COBRA qualifying event.
11-3 In Personnel Administration terminate the employee

Personnel Actions screen
From Enter 01.06.19YY (YY is current year)
Leaving Selected
1. In the Actions (Infotype 0000) screen accept the defaults by selecting Save twice.
2. In the Basic Pay (Infotype 0008) screen select the basic pay record then Delimit.
11-4 In Benefits collect the termination as a COBRA qualifying event.

1. Choose Administration -> COBRA administration.
2. Select Events.
3. In the Collection of qualifying COBRA events pop-up box enter the following:
4. Choose process.
The COBRA qualifying event Termination is now collected for your employee. The
system stores this information in a buffer, that it then accesses via letter printing for
COBRA.
(C) SAP AG HR325 16-44

Unit: Reports and Tools

Run a report to display employee health plan costs.
You need to run the following reports and examine the results.
Health care premiums
Overview of Benefits Plans
12-1 Run the Health care premiums report

Choose Reporting -> Premiums -> Health
In the Health premiums report screen enter the following:
Choose Execute.
12-2 Run the Plan overview report

In the Benefits IMG
Choose the Plan overview IMG node
In the Overview of Benefit Plans report screen enter the following:
Benefit area Enter your benefit area
Choose Execute.
Open out the tree and examine the benefit plan set up that you have created.
In Personnel Administration terminate the employee
(C) SAP AG HR325 16-45

R/3 System
Release 4.0
HR325
Solutions
Note: There may not be enough time to do all the exercises during
the course. The exercises are intended to be additional examples
that are dealt with during the course if required. Participants can
also use them to deepen their knowledge after the course.
(C) SAP AG HR325 17-1

Unit: Customizing Benefits

Organize a benefit program according to R/3 benefit category, type and
plan
You are planning the set up of your benefits plans and you need to
categorize them for configuration.
1-2 Non-system (paper) exercise: Assign the following list of your companys plans to the
benefits categories and types in the structure below. Two have already been done for
you.
ID Long Text

Organization
LIF1 Basic Life
ACCS Access Savings
STLF Standard Life
401K 401K Savings Plan
CAR Company Car
CLUB Country Club membership
(C) SAP AG HR325 17-2

Fill in the structure below:
Health STMD Standard Medical

Organization
STLF Standard Life

Insurance
LIF1 Basic Life
ACCSA Access Savings

Savings
401K 401K Savings

Credit
CAR Company Cra

Miscellaneous
CLUB Country Club
Membership
(C) SAP AG HR325 17-3

(C) SAP AG HR325 17-4
Now go to the IMG
1-2 Set current benefit area

Set the current benefit area. (Your benefit area will be assigned to you by your
instructor.) All the work you do as of now, will be done in your benefit area.
1-3 Define dependents and beneficiaries

Define the following individuals as dependents and beneficiaries:
(Assigned by instructor)
Subtype Name of subtype Dependent Beneficiary
1 Spouse
2 Child
6 Step-child
11 Father
12 Mother
1-4 Define benefit plan types

You define the benefit plan types within the pre-defined benefit plan categories. When
you later define the plans themselves, you assign these to a type. Define the following
benefit plan types and enter the appropriate category:
Type Type name Category
MEDI Medical A
DENT Dental A
LIFE Life Insurance B
SPLF Supp. Life B
AD&D AD&D B
SAVE Standard Saving C
LTSV Long Term Save C
(C) SAP AG HR325 17-5

DPSP Dep Spend Acc D
HCSP Health Sp Acc D
CAR Company Car E
LEIS Leisure E
CLUB Cntry Club Mem E
CRED Credit 1
1-5 Define benefit plan status

Define the following statuses:
Status Status name Active Enroll Description (not used

as input data)
OP Open Active enrollment

allowed, contains
participants
CL Closed Inactive - no
enrollment, no-one
participating
LO Locked Locked no
enrollment but can
have participants
(C) SAP AG HR325 17-6

Unit: Health Plans

Set up a health plan that includes the following:
Options
Dependent coverages
Cost formulas
You need to set up two health plans for your benefit area.
Standard Medical has two options: a deductible and a non-deductible.
Cost of the plan depends on which option the employee chooses and
whether family members are included in the plan. Also whether the
employee is salaried or hourly paid affects the cost of the plan

For Standard Medical, enter the following data:
Field Input data
Benefit plan SM## (## = group number) / Standard Medical
From/to 01.01.1900-31.12.9999
Type MEDI
Plan status OP
Health plan Dependent relevant, Credits, Pre-tax allowed and

attributes post tax allowed
(C) SAP AG HR325 17-7

Enter the two options for the Standard Medical health plan.
Field Input data
Health plan options NODT no deductible
YSDT deductible
2-3 Define dependent coverage options

Define the dependent coverage options as follows:
Dependent Text Maximum dependents

coverage
EE Employee only 0
EE1 Employee plus one 1
EEF Employee plus family 20

rule.
Enter the six cost formulas for each combination of option and dependent coverage as
follows:
Cost Description Period Variable

formula
DEE Deductible EE only 01 Selected
DEE1 Deductible EE plus one 01 Selected
DEEF Deductible EE plus family 01 Selected
NDEE No deductible EE only 01 Selected
NDE1 No deductible EE plus one 01 Selected
(C) SAP AG HR325 17-8

NDEF No deductible EE plus 01 Selected
family

DEE - Deductible EE only
Cost Validity dates Total Employer Provider
group costs costs costs
HRLY 01.01.1900- $200 $175 $200

31.12.9999
SLRY 01.01.1900- $200 $190 $200

31.12.9999
DEE1 - Deductible EE plus one

Cost Validity dates Total costs Employer Provider
group costs costs
HRLY 01.01.1900- $200 $150 $200

31.12.9999
SLRY 01.01.1900- $200 $170 $200

31.12.9999
DEEF - Deductible EE plus family

Cost group Validity dates Total costs Employer Provider
costs costs
HRLY 01.01.1900- $200 $100 $200

31.12.9999
SLRY 01.01.1900- $200 $125 $200

31.12.9999
NDEE No Deductible EE only

costs costs
(C) SAP AG HR325 17-9

HRLY 01.01.1900- $400 $365 $400
31.12.9999
SLRY 01.01.1900- $400 $390 $400

31.12.9999
NDE1 No Deductible EE plus one

costs costs
HRLY 01.01.1900- $400 $350 $400

31.12.9999
SLRY 01.01.1900- $400 $390 $400

31.12.9999
NDEF No Deductible EE plus family

Cost group Validity Total costs Employer Provider
dates costs costs
HRLY 01.01.1900- $400 $200 $400

31.12.9999
SLRY 01.01.1900- $400 $250 $400

31.12.9999

Assign all the attributes for health plans, by assigning options and dependent coverage
choices to cost formulas:
Option Dependent Form. Validity dates
coverage
YSDT EE DEE 01.01.1900-31.12.9999
YSDT EE1 DEE1 01.01.1900-31.12.9999
YSDT EEF DEEF 01.01.1900-31.12.9999
NODT EE NDEE 01.01.1900-31.12.9999
NODT EE1 NDE1 01.01.1900-31.12.9999
(C) SAP AG HR325 17-10

NODT EEF NDEF 01.01.1900-31.12.9999
2-7 Define additional documents for health.

Define health plan SMxx as requiring Evidence of Insurability(EOI). All options
require it upon initial enrollment in the plan. The action the system should take is
create a pending record for the desired option, and allow a grace period of 1 month
from enrollment date.
Options which Initial Action Grace Validity
require proof enrollment? period dates
YSDT and Create 1 month 01.01.1900-

NODT pending from 31.12.9999
record for enrollment
desired date
option

Field Wage type
EE pre-tax contribution BE10
EE posttax contribution BE10
ER contribution BR10
Provider cost BSAL
Now set up the second health plan in your benefit area.

Standard Dental has only one option. Cost of the plan depends solely on whether the
employee is salaried or hourly paid.

For Standard Dental, enter the following data:
Field Input data
Benefit plan SD## (## = group number) / Standard Dental
From/to 01.01.1900-31.12.9999
(C) SAP AG HR325 17-11

Type DENT
Plan status OP
Health plan attributes Dependent relevant, Credits, Pre-tax allowed and

Post tax allowed
(C) SAP AG HR325 17-12

Enter the option for the Standard Dental health plan.
Field Input data
Health plan options OPT1 Option 1

rule.
Enter the cost formula that will be used for all combinations of option and dependent
coverage as follows to the Standard Dental health plan:
formula
ALL All costs 01 Selected

ALL All costs
Cost Validity dates Total Employer Provider
group costs costs costs
HRLY 01/01/1900- $100 $90 $100

31/12/9999
SLRY 01/01/1900- $100 $80 $100

31/12/9999
(C) SAP AG HR325 17-13

Assign attributes to the Standard Dental health plan for the options and dependent
coverage choices.
Option Dependent Form. Validity dates

coverage
OPT1 EE ALL 01.01.1900-31.12.9999
OPT1 EE1 ALL 01.01.1900-31.12.9999
OPT1 EEF ALL 01.01.1900-31.12.9999
2-14 Assign wage types.

Assign wage types to benefit plan SD##.
Field Wage type
EE pre-tax contribution BE11
Provider cost BSAL
(C) SAP AG HR325 17-14

Unit: Insurance plans

Set up an insurance plan to include the following:
Coverage and cost formulas
EOI
Set up two insurance plans for your benefit area.

Basic Life has two flat coverage options, however the actual amount of
coverage differs depending on the employee's personnel group. Cost of
the plan depends on the employee's personnel group and age.
The plan is considered imputed income and the employee can pay for it
using credit allocated in a credit plan.

Field Input data
Benefit plan BL## (## = group number) / Basic Life
From/to 01.01.1900-31.12.9999
Type LIFE
Plan status OP
Provider Legal and General
Insurance plan Beneficiaries and Contingency

attributes beneficiaries relevant.
Pre and post tax premium payments

are allowed.
(C) SAP AG HR325 17-15

Enter the two coverage formulas for Basic Life.
Coverage formula Description Coverage group
LEV1 Level One
LEV2 Level Two

Define the four coverage formula calculation rules as follows. Use validity dates
01.01.1900-31.12.9999.
Coverage Coverage group Basic amount
formula
LEV1 COG1 Salary factor: 1
LEV2 COG1 Amount: $80,000
calculation rule.
In the Basic Life plan, cost is directly proportional to how much coverage the
employee chooses. Thus only one cost formula is required.
3-4 Define criteria identifiers

Define criteria ID in the basic settings for the employee groups:
Criteria ID Text
US Universal
3-5 Define age groups

Define age groups in the basic settings for the employee groups.
An age group is associated with a criteria identifier. The age group defines a specific
age span by associating high and low values with an age group.
(C) SAP AG HR325 17-16

Age group Text Minimum Maximum
age age
<35 Less than 35 years 1 34
>35 More than 35 years 35 99

Define cost formulas for the Basic Life Insurance plan
Field Data
Cost formula ALL
Description All
Period Monthly
Criteria ID US
Age
Variable

Define the four cost formula calculation rules for the cost formula ALL as follows:
Age Cost Validity Base Total Provider
group group dates unit costs costs cost
cost factors
factor
<35 HRLY 01.01.1900- $1000 $0.25 $0.25

31.12.9999
<35 SLRY 01.01.1900- $1000 $0.25 $0.25

31.12.9999
>35 HRLY 01.01.1900- $1000 $0.50 $0.50

31.12.9999
>35 SLRY 01.01.1900- $1000 $0.20 $0.20

31.12.9999
(C) SAP AG HR325 17-17

-8 Assign insurance plan attributes
Assign the attributes for Basic Life, by defining options and assigning the cost and
coverage formulas you have already defined:
Description Cost Coverage Validity dates
formula formula
Option 1 ALL LEV1 01.01.1900-

31.12.9999
Option 2 ALL LEV2 01.01.1900-

31.12.9999
Assign the wage types to Basic Life as follows:
Field Wage type
EE contribution BE20
Provider wage type BR20
Calculation base BSAL
Now set up the second insurance plan in your benefit area.
Additional Life has only one option, however the actual amount of coverage differs
depending on the employee's personnel group (salaried or hourly paid). Cost of the
plan also depends on whether the employee is salaried or hourly paid.

For Additional Life, enter the following data:
Field Input data
Benefit plan AL## (## = group number) / Additional

Life
(C) SAP AG HR325 17-18

From/to 01.01.1900-31.12.9999
Type SPLF
Plan status OP
Provider Prudential
Insurance plan attributes Beneficiaries and Contingency

beneficiaries relevant.
Pre and post tax premium payments

are allowed.
Enter the coverage formula for Additional Life.

Coverage formula Description Coverage group
ALL All coverages

Define the two coverage formula calculation rules as follows.
Coverage Coverage Basis Additional Maximum units
formula group amount coverage
unit
ALL COG1 $10,000 $1,000 90
ALL COG2 $25,000 $5,000 20
calculation rule. In the Additional Life plan, cost is directly proportional to how much
coverage the employee chooses. Thus only one cost formula is required.
(C) SAP AG HR325 17-19

Enter the coverage formula for the Additional Life insurance plan.
Field Data
Cost formula ALL
Description All
Period Monthly
Variable

Define the cost formula calculation rules for the cost formula ALL as follows:
Cost group Validity Base unit Total costs Provider
dates costs
Cost
Factor Cost Factor
HRLY 01.01.1900- $1000 $0.35 $0.35

31.12.9999
SLRY 01.01.1900- $1000 $0.25 $0.25

31.12.9999

Assign the attributes for Additional Life, by defining the one option and assigning the
cost and coverage formulas you have already defined:
Descriptio Cost formula Coverage Validity dates
n formula
Option 1 ALL ALL 01.01.1900-

31.12.9999
(C) SAP AG HR325 17-20

3-16 Define additional documents for Insurance
Define this plan as requiring Evidence of Insurability(EOI) upon initial enrollment in
the plan, an increase of $25,000 or more, or when a total of $100,000 coverage or more
is chosen. The action the system should take is create an active record for the desired
option, and allow a grace period of 1 month from enrollment date.
Field Data
Benefit plan AL## (## = group number) / Additional

Life
Initial enrollment $0.01
Change of coverage $24,999
Enrollment any time $100,000
Grace period 1 month from enrollment date
Validity dates 01.01.1900-31.12.9999

Assign the wage types to Additional Life as follows:
Field Wage type
Provider wage type BR20
(C) SAP AG HR325 17-21

Unit: Savings Plans

Set up a savings plan to include the following:
Employee contributions for pre and post tax
Vesting rules
Investment options
Set up two savings plans for your benefit area.

In the Standard Savings, the employee may contribute pre-tax up to $500
and post tax up to $1000 per month. The plan is a guaranteed annuity
plan.

For Standard Savings, enter the following data:
Field Input data
Benefit plan SS## (## = group number) / Standard

Savings
From/to 01.01.1900-31.12.9999
Type SAVE
Plan status OP
Savings plan attributes Beneficiaries, Contingency beneficiaries

and Investments relevant.
(C) SAP AG HR325 17-22

Define employee contribution rules for the Standard savings plan.
Field Data
Description All
Period Monthly

Define employee contribution rule criteria for the Standard savings plan for the ALL
employee contribution rule.
Field Data
Amount
Pre-tax
Pre-tax minimum $100
Pre-tax maximum $500
Post-tax
Post-tax minimum $100
Post-tax maximum $1000
Validity dates 01.01.1900-31.12.9999
4-4 Define investments

Investments for savings plans are the options available to employees participating in
the benefit program. Investment options are available to savings plan participants.
Define the following investments for your savings plans:

Investment Text
ANNU Guaranteed annuity
BLFD Balanced fund
COMP Company stock
(C) SAP AG HR325 17-23

4-5 Define investment groups
Investment groups are used to associate several investment options with a benefit plan.
A benefit plan then has an investment group consisting of several options.
Investment group Text
SAV Savings
401K 401K
4-6 Assign investments to groups

Individual options are associated with investment groups:
Investment group Investment
SAV ANNU
401K BLFD, COMP

The attributes of the savings plan are assigned to the plan itself, as follows:
Field Data
Benefit plan SS##
Investment group SAV
Validity dates 01.01.1900-31.12.9999

Assign the wage types to Standard Savings as follows:
Field Wage type
EE posttax deducs BE30
(C) SAP AG HR325 17-24

Now set up the second savings plan in your benefit area.
In the Standard 401K, employees may contribute pre-tax up to 15% and post-tax up to
10% of their income per month. The employer matches 10% up to different maximum
limits, depending on the length of service of the employee.

For Standard 401K, enter the following data:
Field Input data
Benefit plan S4## (## = group number) / Standard 401K
From/to 01.01.1900-31.12.9999
Type LTSV
Plan status OP
Provider Prudential
Savings plan Beneficiaries, Contingency beneficiaries and

attributes Investments relevant

Define employee contribution rules for the Standard 401k plan.
Field Data
Description All
Period Monthly

Define employee contribution rule criteria for the Standard 401k plan for the ALL
employee contribution rule.
Field Data
Percent
Pre-tax
Pre-tax minimum 1%
(C) SAP AG HR325 17-25

Pre-tax maximum 15%
Post-tax
Post-tax minimum 1%
Post-tax maximum 10%
Pre-tax contribution limit $10,000
Validity dates 01.01.1900-31.12.9999
4-12 Define employer contribution rules

Define employer contribution rules for the Standard 401k plan.
Field Data
Description All
Period Monthly
Criteria ID Universal
LOS
4-13 Define length of service groups in the basic settings for the employee groups for the
Universal criteria ID.
Field Data
LOS group <10 Less than 10 years
Lowest value 1
Max. value 9
LOS group >10 More than 10 years
Lowest value 10
Max. value 99
(C) SAP AG HR325 17-26

4-14 Define employer contribution rule criteria
Define employer contribution rule criteria for the Standard 401k plan for the ALL
employer contribution rule.
LOS Sequ. Contribution Contributio Validity dates
Group No. definition n limit
<10 1 10% ee contribution $10,000 01.01.1900-

31.12.9999
>10 1 10% ee contribution $15,000 01.01.1900-

31.12.9999
4-15 Define vesting rules.

A vesting rule defines a particular schedule. Define your vesting rule as follows:
Field Data
Vesting rule 5YR
Description 5 Year Vesting
4-16 Define vesting schedules

Define vesting schedules for the 5YR vesting rule.
Percent Number Unit
20 1 Years
40 2 Years
60 3 Years
80 4 Years
100 5 Years
(C) SAP AG HR325 17-27

The attributes of the 401k savings plan are assigned to the plan itself, as follows:
Field Data
Benefit plan S4##
EE contr. Rule ALL
ER contr. Rule ALL
Vesting rule 5YR
Investment group 401K
Validity dates 01.01.1900-31.12.9999

Assign the wage types to Standard 401K as follows:
Field Wage type
Technical base BSAL
(C) SAP AG HR325 17-28

Unit: Flexible Spending Accounts (US only)

Set up an FSA to include:
employee contribution
Set up two FSAs for your benefit area.

In the Health Care FSA, the employee may contribute pre-tax up to
$10,000 annually.

For Health Care FSA enter the following data:
Field Input data
Benefit plan HF## (## = group number) / Health Care FSA
From/to 01.01.1900-31.12.9999
Type HCSP
Plan status OP
(C) SAP AG HR325 17-29

Enter the details of the Health Care FSA plan as follows:
Field Input data
Minimum amount $100
Validity period 01.01.1900 31.12.9999
Benefit plan HF## (## = group number)
Reimbursement of claims BE40

wage types
Minimum reimbursement $100

amount
Maximum availability Annual contribution

Enter the following wage type for the Health Care FSA plan:
Field Input data
EE contribution BR40
Now enter the details of the other FSA in your benefit area.
In the Dependent Care FSA, the employee may contribute pre-tax up to $15,000
annually.

For Dependent Care FSA enter the following data:
Field Input data
Benefit plan DF## (## = group number) / Dependent

Care FSA
From/to 01.01.1900-31.12.9999
Type DPSP
Plan status OP
(C) SAP AG HR325 17-30

Provider Prudential

Enter the details of Dependent Care FSA as follows:
Field Input data
Benefit plan DF## (## = group number)
Minimum amount $100
Reimbursement of claims BE41

wage types
Minimum reimbursement $100

amount
Validity period 01.01.1900 31.12.9999
Maximum availability Current account balance
5-6 Assign wage types for the Dependent Care FSA plan.
Enter the following wage type:
Field Input data
EE contribution BR41
5-7 Define FSA claim receipt types

Enter the following receipt types:
Receipt type Text
DAYC Day care
HOSP Hospital visit
(C) SAP AG HR325 17-31

(C) SAP AG HR325 17-32
Unit: Credit Plans

Set up a credit plan to include a credit formula and wage types.
Set up a credit plan for your benefit area.

In the Flexible Credit plan the employees receive an amount of credit,
depending on whether they are salaried or hourly paid employees. This
credit can then be used to pay for other benefit plans.
6-1 Define credit plan general data

For Flexible Credit, enter the following data:
Field Input data
Benefit plan FCXX (XX = group number) / Flexible Credit
From/to 01.01.1900-31.12.9999
Type CRED
Plan status OP
6-2 Define credit formulas

A credit formula is the means of determining the amount of money an employer will
distribute to employees in order to pay for their other benefit plans. The cost formula is
defined in two steps. In step one, you identify the credit formula name and the credit
criteria. In step two you specifically define the credit criteria.
Define the credit formula for Flexible Credit as follows:
(C) SAP AG HR325 17-33

Field Data
Credit formula SIMP
Description Simple credits
Period Monthly
Credit group
6-3 Define credit formula calculation rules

Define credit formula calculation rules for the Flexible Credit plan for credit formula
SIMP.
Credit Credit Roundin Rounding Min. Max.
group factor g rule divisor amount amount
HRLY 2.5 A 100 $20 $300
SLRY 5.0 A 100 $50 $500
Validity period 01.01.1900 31.12.9999
6-4 Assign credit plan attributes

Assign credit plan attributes for the flexible credit plan.
Field Data
Validity dates 01.01.1900 31.12.9999
Credit formula SIMP
Excess % 50

Assign the wage types to Flexible Credit as follows:
Field Wage type
(C) SAP AG HR325 17-34

Unit: Miscellaneous Plans
At the conclusion of this exercise, you will be able to set up miscellaneous

plans to include
Cost formula
Cost formula calculation rules
Set up two miscellaneous plans for your benefit area.
The Company Car plan offers two types of car, luxury and sport.
Employees pay a higher premium if they live beyond a 20 mile radius of
the office.

Field Input data
Benefit plan CC## (## = group number) / Company

Car
From/to 01.01.1900 31.12.9999
Type CAR
Plan status OP
4 Cost formula
4 Post tax allowed

For the Company Car cost formulas, enter the following data:
formula
(C) SAP AG HR325 17-35

LUXY Luxury car Monthly
SPRT Sports car Monthly

Define the two cost formula calculation rules for each cost formula as follows:
Cost formula Cost group Validity dates Total costs
LUXY FAR 01.01.1900 31.12.9999 $330
LUXY NEAR 01.01.1900 31.12.9999 $300
SPRT FAR 01.01.1900 31.12.9999 $220
SPRT NEAR 01.01.1900 31.12.9999 $200

Assign the attributes for Company Car, by defining options and assigning the cost
formulas you have already defined:
Option Description Cost formula Validity dates
LUXY Luxury car option LUXY 01/01/1900-

31/12/9999
SPRT Sports car option SPRT 01.01.1900

31.12.9999

Assign the wage types to Company Car as follows:
Field Wage type
Now set up the second miscellaneous plan in your benefit area.
(C) SAP AG HR325 17-36

The Health Club plan offers membership in the club for a flat monthly cost. The cost is the
same for all employees.

For Health Club, enter the following data:
Field Input data
Benefit plan HC## (## = group number) / Health Club
From/to 01.01.1900-31.12.9999
Type LEIS
Plan status OP
4 Cost formula
4 Post tax allowed

For the Health Club cost formula, enter the following data:
Cost formula Description Period
CLUB Club membership Monthly

Define the cost formula calculation rule for the health club plan and the CLUB cost
formula as follows:
Cost formula Validity dates Total costs
CLUB 01.01.1900 31.12.9999 $100

Assign the attributes for Health Club, by defining the option and assigning the cost
formula you have already defined:
Option Description Cost formula Validity dates
CLUB Club CLUB 01.01.1900
(C) SAP AG HR325 17-37

membership 31.12.9999

Assign the wage types to the Health Club plan as follows:
Field Wage type
Unit: Benefits Administration
At the conclusion of this exercise, you will be able to set up:

Pre-requisites and co-requisites
Benefit programs
Eligibility and termination rules
Standard plans
Benefit events
Benefit parameters
Set up the administration of the benefit plans you have defined for your
benefit area.
8-1 Define administrative parameters

For your administrative parameters, enter the following data:
Field Input data
Is an Open Enrollment period Yes

offered?
Open enrollment validity 01.11.19YY 30.11.19YY

(YY is current year)
Validity of records for open 01.01.19ZZ 31.12.19ZZ (

enrollment ZZ is current year +1)
Validity of records for 31.12.19YY (YY is current year)

event/standard plans
(C) SAP AG HR325 17-38

Maximum permitted age of Non student: 18
dependents Student: 21
No maximum age if physically

challenged
Prerequisite plans are those plans the employee must be enrolled in before it is possible
to enroll in another particular plan. An employee can enroll a particular plan and its
corequisite plans all at the same time.
8-2 Define prerequisite plans

For plan Additional Life (AL## ## is your group number), define the following
prerequisite plan:
Prereq. Description Prerequisite Any plan
BL## Basic Life
8-3 Define corequisite plans

For plan Standard Dental (SD## ## is your group number), define the following
corequisite plan:
Coreq. plan Description Corequisite Any plan
SM## Standard Medical
Set up the benefit programs for your employees. First you define benefit groups and
employee statuses. Next you define eligibility and termination rules. Lastly for each
combination of benefit group and employee status, you define the program of plans for
which they are eligible, and attach the eligibility and termination rules to the plans.
8-4 Define employee benefit groups

Define the following employee benefit groups:
Benefit group Text
EXEC Executive employees
EXMT Exempt employees
HRLY Hourly employees
8-5 Define employee status

Define the following employee statuses:
(C) SAP AG HR325 17-39
Benefit group Text
PART Part time employees
TEMP Temporary employees
Now define the eligibility groups, rules and rule criteria.
8-6 Define eligibility groups

An eligibility group is a means of identifying groups of employees possessing common
characteristics relevant to the eligibility requirements of the benefits offered by your
organization. The eligibility group allows you to include supplementary eligibility
criteria that are not included in the standard eligibility criteria.
Define the following eligibility group:
Eligibility group Text
EGR1 Eligibility group 1
8-7 Define eligibility rules

Define the following eligibility rule:
Eligibility rule Text
IMMD Immediately eligible
8-8 Define eligibility rule criteria

Define the following eligibility rule criteria for eligibility rule IMMD and eligibility
group EGR1:
Eligibility group Text
Elig. Group EGR1
Field Data
Validity dates 01.01.1900 31.12.9999
Enrollment Immediate
(C) SAP AG HR325 17-40

8-9 Define termination types
A termination type is a means of identifying types of employees possessing common

characteristics relevant to the termination requirements of your organization. The
termination type allows you to include supplementary criteria that are not included in
the standard termination criteria.
Define the following termination types:
Termination type Text
TTYP Standard termination
8-10 Define termination rules

Define the following termination rule:
Termination rule Text
IMMD Immediate termination.
RUL1 Rule 1
RUL2 Rule 2
8-11 Define termination rule criteria

Define the following termination rule criteria for each combination of termination rule
and termination type:
Term. Term. Validity Cov. Cont. Termination
rule type dates period
IMMD TTYP 01.01.1900 blank Immediately

31.12.9999
RUL1 TTYP 01.01.1900 4 months Day 31

31.12.9999 month
RUL2 TTYP 01.01.1900 1 month Immediately

31.12.9999
8-12 Define benefit programs

Define the benefit program for employees who fall into the benefit group EXMT and
the employee status FULL termination type:
Plan Description Eligibility rule Termination rule
SM## Standard medical IMMD RUL1
(C) SAP AG HR325 17-41

SD## Standard Dental IMMD RUL1
BL## Basic Life IMMD RUL2
AL## Additional Life IMMD RUL2
SS## Standard Savings IMMD IMMD
S4## Standard 401K IMMD IMMD
FC## Flexible Credit IMMD IMMD
CC## Company Car IMMD IMMD
HC## Health Club IMMD IMMD
US only:
HF## Health Care FSA IMMD RUL1
DF## Dependent Care FSA IMMD RUL1
8-13 Define standard health plans

Define the following plans as default health plans, for EXMT and FULL employees:
Type Plan Option Dependent Processing
coverage type
MEDI SM## NODT EE Default plan
DENT SD## OPT1 EE Default plan
8-14 Define standard insurance plans

Define the following plans as default insurance plans, for EXMP and FULL
employees:
Type Plan Option Additional units Processing type
LIFE BL## OPT1 blank Default plan
A Benefit event is when an employee wants to make changes to enrollments due to a life or
organizational change. You can define the events and specify permissions for change in each
case. You can also define benefit event groups to allocate different permissions to different
groups of employees.
8-15 Define benefit event groups
(C) SAP AG HR325 17-42

Define the following benefit event group:
Event group Text
STRD Standard event group
8-16 Define benefit events

Define the benefit event CHIL New child:
End of records Default date (31.12.19YY YY =
current year)
Define the benefit event NRES No reason:

Field Data
Event NRES No reason
Changes anytime
Total event process duration Blank
Event process duration after first Blank

choice
Start of records : Event date (31.12.19YY YY

= current year)

current year)
Define the benefit event INIT Initial enrollment:

Field Data
Event INIT Initial enrollment
Changes anytime Blank
Total event process duration 6 weeks
(C) SAP AG HR325 17-43

Event process duration after first 6 weeks
choice
Start of records : Event date

current year)
Define the benefit event MARR Marriage:

Field Data
Event MARR Marriage
Total event process duration 2 months
Event process duration after first 1 month

choice
Start of records Event date

current year)
Define the benefit event ORGC Organizational change:

Field Data
Event ORGC Org. change
Total event process duration 6 weeks
Event process duration after first Blank

choice
Start of records Event date (31.12.19YY YY

= current year)

current year)
(C) SAP AG HR325 17-44

Define the permitted changes for the health and savings plans in your benefit area.
8-17 Define permitted changes for events -> Health plans

Define changes by plan type.
Event Event Plan type Selected

group
INIT STRD MEDI Create
INIT STRD DENT Create
CHIL STRD MEDI Change:

option
dependent coverage
dependents
CHIL STRD DENT Change:

option
dependent coverage
dependents
8-18 Define permitted changes for events -> Insurance plans

group type
INIT STRD LIFE Create
CHIL STRD LIFE Change:

option
beneficiaries
Create:
plan
CHIL STRD SPLF Change:

option beneficiaries
Create:
plan
8-19 Define permitted changes for events -> Savings plans

(C) SAP AG HR325 17-45

group type
INIT STRD SAVE Create
INIT STRD LTSV Create
CHIL STRD SAVE Change:

Beneficiaries
Increase:
Pre tax contrib
Post tax contrib
CHIL STRD LTSV Change:

Beneficiaries
Increase:
Pre-tax contribution
8-20 Define permitted changes for events -> Credit plans

group type
INIT STRD CRED Create
8-21 Define permitted changes for events -> Miscellaneous plans

group type
INIT STRD CAR Create
INIT STRD LEIS Create
CHIL STRD CAR Change:

option
CHIL STRD LEIS Change:

plan
Create:
plan
8-23 USA Only: Define permitted changes for events -> Flexible spending accounts
(C) SAP AG HR325 17-46

group type
INIT STRD DPSP Create
INIT STRD HCSP Create
CHIL STRD DPSP Change:

benefit plan
Create:
benefit plan
Delete:
benefit plan
Increase:
contribution
Decrease:
contribution
CHIL STRD HCSP Change:

benefit plan
Create:
benefit plan
Delete:
benefit plan
Increase:
contribution
Decrease:
contribution
Unit: COBRA (US Only)

Identify plans that are valid for COBRA
When US employees leave the company, they may be eligible to continue

their benefits under COBRA provisions. You need to flag plans valid for
COBRA.
Choose the plans valid for COBRA from those health plans you have already set up.
9-1 Choose COBRA plans

Enter the following data:
(C) SAP AG HR325 17-47

Plan COBRA valid
SD## (Standard dental) blank
SM## (Standard medical)
(C) SAP AG HR325 17-48

Unit: Benefits Processing

Enroll a newly hired employee in benefits plans
Hire an employee in Personnel Administration, then enroll the employee

in Benefits for benefit plans. Use the benefits event Initial enrollment to
enroll the employee. Then carry out EOI processing using the HR325
hiring action.
10-1 In Personnel Administration hire the employee

Personnel Action screen
Field Data
From 01.01.19YY (YY is current year)
HR325 Hiring
Enter the data for each infotype for the action HR325 Hiring as follows:
Actions (Infotype 0000)

Field Data
Position Blank
Personnel area 3000
Employee group 1
Employee subgroup U4
Personal Data Infotype (0002)

Field Data
(C) SAP AG HR325 17-49

Last name Your choice
SSN Your choice
Birth date 03.04.1968
Gender Your choice
Marital status Marr

Field Data
SSN Your choice
Organizational assignment (Infotype 0001)

Field Data
Payroll subarea 0001
Payroll area US
Note: Select the Cancel icon on the Enter Position Assignment pop-up box
Address (Infotype 0006)

Field Data
Address line 1 44## Oak Lane
City SAPBerg
State/zip code OH/44574
Select the Cancel icon in the Tax area pop-up box.

Select the Cancel icon in Residence Tax Area (Infotype 0207).
(C) SAP AG HR325 17-50

Planned Working Time (Infotype 0007)
Field Data
Work Schedule Rule NORM
Basic pay (Infotype 0008)

Field Data
Payscale group GRD01
Annual salary 30,000
Family/Related Person (Infotype 0021)

Data
SSN Your choice
Gender Your choice
General benefits data (Infotype 0171)

Field Data
Benefit area Override with your benefit area
Benefit group EXMT (default)
Employee status FULL (default)
Event: permissions (Infotype 0378)

Field Data
Benefit event INIT Initial enrollment
Validity dates 01.01.19YY 12.02.19YY (YY is current

year)
10-2 In Benefits enroll the employee in benefit plans

(C) SAP AG HR325 17-51

In the Benefits - Main Program pop-up box enter the following:
Field Data
Choose Execute.
Click on the Enroll icon next to the line Initial enrollment.
Plan Other data
Flexible credit None
Standard Dental Option 1

Employee only
Standard Medical With deductible

Employee only
Basic Life Option 2
Standard Savings Pre-tax contribution $100
Company Car Sports car option
Health Club None
Choose Enroll.
In the EOI pop-up box leave the checkbox blank to indicate that EOI had not yet been
provided by the employee.
Choose Enroll.
Choose Enroll.
10-3 In Benefits process the employee's EOI.
You have just enrolled your employee in Standard Medical. However since EOI had
not at that time been provided, the system created the plan as pending only.
(C) SAP AG HR325 17-52

It is now 2 weeks later and the employee has just delivered the EOI to the benefits
office. You should now record this in the system.
In the Benefits Main Program

Choose the Insurability function.
Field Data
Choose Execute.
Select the plan Standard Medical and then the EOI provided function.
The employee's Standard Medical plan is now active and the record states that EOI has
been provided.
(C) SAP AG HR325 17-53

Topic: FSA Processing
Enroll an employee in an FSA.
Your company offers Flexible Spending Accounts,and you want to enroll
an employee.
11-1 In Benefits enroll the employee in an FSA benefit plan.

Benefits screen
Field Data
Choose Execute.
Click on the enroll icon next to the line Initial enrollment.
Plan Other data
Health Care FSA $1000 annual contribution
Dependent Care FSA $1000 annual contribution
Choose Enroll.
Choose Continue.
11-2 Process a check your employee has brought to the benefits office for processing.
Benefits screen
Choose the Administration -> Spending accounts claims.
(C) SAP AG HR325 17-54

Field Data
Today
Choose Execute.
Put your cursor on the Dependent Care spending account and select the Claims icon.
In the pop-up box select Create.
In the FSA Claims (Infotype 0172) enter the following:
FSA Claims (Infotype 0172)

Field Data
Benefit plan type DPSP
Claim submitted on Enter today's date
Date cost incurred Enter yesterday's date
Claim $100
Receipt type DAYC
Save your entries.

Return to the screen FSA: Administration and Balancing.
A claim now exists in the system and can be accessed by Payroll processing.
(C) SAP AG HR325 17-55

Topic: Cobra Processing

Terminate an employee and collect the COBRA event
Now terminate your employee's employment contract and collect this as a
COBRA qualifying event.
11-3 In Personnel Administration terminate the employee
Personnel Actions screen

Field Data
From Enter 01.06.19YY (YY is current year)
Leaving
3. In the Actions (Infotype 0000) screen accept the defaults by selecting Save twice.
4. In the Basic Pay (Infotype 0008) screen select the basic pay record then Delimit.
11-4 In Benefits collect the termination as a COBRA qualifying event.

1. Choose Administration -> COBRA administration.
2. Select Events.
3. In the Collection of qualifying COBRA events pop-up box enter the following:
Field Data
(C) SAP AG HR325 17-56

4. Choose process.
The COBRA qualifying event Termination is now collected for your employee. The
system stores this information in a buffer, that it then accesses via letter printing for
COBRA.
(C) SAP AG HR325 17-57

Unit: Reports and Tools

Run a report to display employee health plan costs.
You need to run the following reports and examine the results.
Health care premiums
Overview of Benefits Plans
12-1 Run the Health care premiums report

Choose Reporting -> Premiums -> Health
In the Health premiums report screen enter the following:
Field Data
Choose Execute.
12-2 Run the Plan overview report

In the Benefits IMG
Choose the Plan overview IMG node
In the Overview of Benefit Plans report screen enter the following:
Field Data
Benefit area Enter your benefit area
Choose Execute.
Open out the tree and examine the benefit plan set up that you have created.
In Personnel Administration terminate the employee
(C) SAP AG HR325 17-58

Appendix
z This section contains supplementary material

to be used as reference
z This material is not part of the standard
course
z Therefore, the instructor might not cover this
during the course presentation
SAP AG
(C) SAP AG HR325 18-1

Main Benefits IMG Paths in 4.6
Prerequisite and Corequisite Plans

Personnel Management > Benefits > Flexible Administration > Prerequisites and corequisites > Define prerequisite
plans
Personnel Management > Benefits > Flexible Administration > Prerequisites and corequisites > Define corequiste
plans

Benefits > Plans > Health Plans > Define evidence of insurability conditions
Benefits > Plans > Insurance Plans > Define evidence of insurability conditions

Benefits > Plans > Savings Plans > Combined contribution > Define combined contribution limits
Benefits > Plans > Savings Plans > Combined contribution > Define combined contribution limit expressions
Combined Coverage for Insurance

Benefits > Plans > Insurance Plans > Combined coverage > Define combined coverage for insurance
Benefits > Plans > Insurance Plans > Combined coverage > Define combined coverage limit expressions
Credit Plans - Excess

Benefits > Plans > Credit Plans > Assign credit plan attributes
Miscellaneous Plans
Benefits > Plans > Miscellaneous Plans >
Administrative Parameters
Benefits > Flexible Administration > Define administrative parameters
Standard Plans
Benefits > Flexible Administration > Standard selections
User Exits
Benefits > Toolset > User exits
COBRA
Benefits > COBRA
(C) SAP AG HR325 18-2

Benefits Infotypes
International:
0167 Health Plans
0168 Insurance Plans
0169 Savings Plans
0379 Stock Purchase Plans
0236 Credit Plans
0377 Miscellaneous Plans
0171 General Benefits Data
0376 Medical Data
0378 Adjustment Reasons
North America/USA only:

0211 COBRA Qualified Beneficiary
(USA)
0212 COBRA Health Plans (USA)
0270 COBRA Payments (USA)
0170 Flexible Spending Accounts
(North America)
0172 FSA Claims (North America)
0375 HCE Information
(C) SAP AG HR325 18-3

Change in Benefits Terminology as of Release 4.6A
The Benefits Component has undergone some terminology changes, to bring transparency and symmetry to the
product. All changes are in keeping with HR terminology standards. The changes concern the following areas:
Customizing:
o names of views
o column headers within views
o field labels within views
Reporting:
o texts and field labels on selection screens
o texts and field labels for lists
o documentation
Dialog:
o field labels
o group boxes
o column headers
o help texts
ABAP Dictionary
o domains (long name)
o data elements (long name and documentation)
o structures (long name)
o tables (long name)
o views (long name)

o funtion modules (long name)
o user exits (long name)
Further Repository Objects:

o transactions (long name)
o features (documentation)
o messages
Please note the following significant changes:
(C) SAP AG HR325 18-4

Up to Release 4.0x As of Release 4.6A
Adjustment group Adjustment grouping
Adjustment permission Adjustment permission
Adjustment reason Adjustment reason
Dependent/Dependant Dependent
Beneficiary Beneficiary
Benefit group First program grouping
Benefits information Benefits information
Benefit status Second program grouping
Calculation rule Rule
Calculation rule for employee contribution Employee contribution rule
Calculation rule for employer contribution Employer contribution rule
COBRA Reason for Early Termination COBRA early termination reason
Combined contribution limit Combined contribution limit
Combined coverage limit Combined coverage limit
Cost formula Cost (rule) variant
Cost formula calculation rule Cost rule
Cost group Cost grouping
Coverage Coverage
Coverage formula Coverage (rule) variant
Coverage formula calculation rule Coverage rule
Coverage group Coverage grouping
Credit Credit
Credit formula Credit (rule) variant
Credit formula calculation rule Credit rule
Credit group Credit grouping
Criteria ID/Criteria identifier Parameter group
Dependent option Dependent coverage
Eligibility group Eligibility grouping
Eligibility rule Eligibility (rule) variant
Eligibility rule criteria Eligibility rule
Employee contribution group Employee contribution grouping
Employee contribution rule Employee contribution (rule) variant
Employee contribution formula Employee contribution (rule) variant
Employee contribution rule criteria Employee contribution rule
Employee group First program grouping
Employee group criteria ID Parameter group
(C) SAP AG HR325 18-5

Employee status Second program grouping
Employer contribution group Employer contribution grouping
Employer contribution rule Employer contribution (rule) variant
Employer contribution formula Employer contribution (rule) variant
Employer contribution rule criteria Employer contribution rule
Event Adjustment reason
Event assigned permissions adjustment permission
Event group Adjustment grouping
Formula (Rule) variant
Health plan Health plan
Health plan option Health plan option
Insurance level Option insurance plan
Insurance option Option insurance plan
Interim Default
Investment Investment
Investment group Investment group
Investment program Investment/investment group assignment
Length of service Seniority
Miscellaneous plan Miscellaneous plan
Permission Eligibility
Plan type Plan type
Proof of insurability Evidence of insurability
Program Program
Related person group Dependent/beneficiary group
Rule (Rule) variant
Rule criteria Rule
Spending account Flexible spending account
Standard plan Standard selection
Termination group/ Termination type Termination grouping
Termination rule Termination (rule) variant
Termination rule criteria Termination rule
Vesting plan Vesting portion
Vesting rule Vesting rule
Vesting schedule Vested portion
Workflow event assignment Adjustment reason/event assignment
(C) SAP AG HR325 18-6

User Exits related to Benefits
User Exit Replaces

PBEN0001 Feature BAREA
PBEN0002 Feature BENGR
PBEN0003 Feature BSTAT
PBEN0004 Feature CSTV1
PBEN0005 Feature CRDV1
PBEN0006 Feature ELIGR
PBEN0007 Feature TRMTY
PBEN0008 Function HR_BEN_CALC_BENEFIT_COST
PBEN0009 Function HR_BEN_CALC_BENEFIT_CREDIT
PBEN0010 Function HR_BEN_CALC_BENEFIT_SALARY
PBEN0011 Function HR_BEN_CALC_COVERAGE_AMOUNT
PBEN0012 Form CALC_ELIG_DATE
PBEN0013 Form CALC_TERM_DATE
PBEN0014 Function HR_BEN_CALC_BENEFIT_ER_CONTRIB
PBEN0015 Form CHECK_ELIG_SERVICE
PBEN0016 Function HR_BEN_CALC_PARTICIPATION_DATE
PBEN0017 Feature EVTGR
PBEN0018 Feature COVGR
PBEN0019 Feature EECGR
PBEN0020 Feature ERCGR
PBEN0022 Function HR_BEN_GET_PROCESS_DATES
PBEN0023 Function HR_BEN_CALC_CUTOFF_AGE
PBEN0024 Function HR_BEN_CALC_CUTOFF_LOS
PBEN0025 Function HR_BEN_CALC_CUTOFF_SAL
PBEN0027 Feature LDAYW
PBEN0028 Function HR_BEN_CALC_Benefit_EE_CONTRIB
PBEN0029 Feature RLPGR
PBEN0030 Function HR_BEN_CALC_LENGTH_OF_SERVICE
PBEN0033 Function HR_BEN_GET_IDOC_EVENTS
PBBENUS01 Years of service calculation (403b)
PBBENUS02 Service date calculation (403b)
PCOB0001 COBRA Letter
PCOB0004 Form HR_BEN_COB_GET_TOTAL_COSTS
(C) SAP AG HR325 18-7

BAPIs for Benefits Administration in Release 4.6A
The Benefits component contains Business Application Programming Interfaces (BAPIs). These
allow other application systems to integrate with SAP R/3 data and processes, using standard
interfaces.
Benefits contains the following BAPIs:
EmployeeBenAdjReason.CalculateEndDate
EmployeeBenAdjReason.Delimit
EmployeeBenAdjReason.GetList
EmployeeBenefit.CheckSelection
EmployeeBenefit.CreateOffer
EmployeeBenefit.CreatePlans
EmployeeBenefit.DeletePlans
EmployeeBenefit.GetCorequisitePlans
EmployeeGenBenInfo.GetOpenEnrollmentPeriod
EmployeeBenefit.GetParticipation
EmpBenefitHealthPlan.GetDependents
EmpBenefitHealthPlan.GetPossDependents
EmpBenefitInsurePlan.GetBeneficiaries
EmpBenefitInsurePlan.GetPossBeneficiarie
EmpBenefitSavingPlan.GetBeneficiaries
EmpBenefitSavingPlan.GetPossBeneficiarie
EmpBenefitSavingPlan.GetInvestments
EmpBenefitSavingPlan.GetPossInvestments
EmpBenefitStockpPlan.GetBeneficiaries
EmpBenefitStockpPlan.GetPossBeneficiaries
EmpBenefitMiscelPlan.GetDependents
EmpBenefitMiscelPlan.GetPossDependents
EmpBenefitMiscelPlan.GetBeneficiaries
(C) SAP AG HR325 18-8
EmpBenefitMiscelPlan.GetPossBeneficiaries
EmpBenefitMiscelPlan.GetInvestments
EmpBenefitMiscelPlan.GetPossInvestments
(C) SAP AG HR325 18-9

Benefits Features
Benefits features are all found at the relevant point in the Benefits IMG.
Technical name Text

BAREA Benefit area
BSTAT Second program grouping
BENGR First program grouping
COVGR Coverage grouping
EECGR Employee contribution grouping
ERCGR Employer contribution grouping
EVTGR Adjustment grouping
CSTV1 Cost grouping
CRDV1 Credit grouping
ELIGR Eligibility grouping
TRMTY Termination grouping
RLPGR Dependent/beneficiary group
(C) SAP AG HR325 18-10


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HR 325 Benefits Administration

R/3 System Release 46C 05/02/2001

Copyright 1999 SAP AG. All rights reserved.

Neither this training manual nor any part thereof may

All rights reserved.

HR325 2 days HR530 3 days

z Benefits implementation project team

(C) SAP AG HR325 1-1

This course will enable you to:

(C) SAP AG HR325 1-2

At the conclusion of this course, you will be able to:

z Configure the Benefits system.

(C) SAP AG HR325 1-3

Unit 6 Savings Plans Unit 13 Payroll Integration

(C) SAP AG HR325 1-4

(C) SAP AG HR325 1-5

(C) SAP AG HR325 1-6

Benefits Reporting &

(C) SAP AG HR325 1-7

z Your company is implementing new benefit plans to

(C) SAP AG HR325 1-8

(C) SAP AG HR325 2-1

At the conclusion of this unit, you will be able to:

z List the benefit plan categories.

(C) SAP AG HR325 2-2

Benefits Reporting &

(C) SAP AG HR325 2-3

z Your company is implementing new benefit

(C) SAP AG HR325 2-4

(C) SAP AG HR325 2-5

(C) SAP AG HR325 2-6

(C) SAP AG HR325 2-7

Adjustment Reasons Offer Benefit plan DENT

(C) SAP AG HR325 2-8

(C) SAP AG HR325 2-9

The current benefits display the enrollment of an employee.

(C) SAP AG HR325 2-10

Open offer Employee Employee

(C) SAP AG HR325 2-11

(C) SAP AG HR325 2-12

Eligibility check 17.08.1999

(C) SAP AG HR325 2-13

(C) SAP AG HR325 2-14

You are now able to:

(C) SAP AG HR325 2-15

(C) SAP AG HR325 3-1

At the conclusion of this unit, you will be able to:

z Describe the concept of benefit areas.

(C) SAP AG HR325 3-2

Benefits Reporting &

(C) SAP AG HR325 3-3

z Your company has several different

(C) SAP AG HR325 3-4

(C) SAP AG HR325 3-5

(C) SAP AG HR325 3-6

Change View Benefit Plan Type: Overview

HR payee 00000001 Prudential Insurance

Provider number 00000000042

Vendor VEND5 Link

A benefit provider is the vendor or carrier of a benefit plan.

(C) SAP AG HR325 3-7

Health Insurance Savings Credit Miscellaneous Spending

(C) SAP AG HR325 3-8