Benefits:

Session 1:
https://www.youtube.com/watch?v=vQG64_dRQ68

Notes:
Benefits: Non monetory Earnings
Insurance, Loan, Company Paid Car
OSB(Enterprise with linear complexity) ---> OAB

ABCD of OAB:
1. Insurance and Carriers
2. Benefit Structure: Program, Plan Types, Plan, Options
3. Life Events
4. Eligibility
5. Electibility
6. Person Types:

Participant
Contact (Family Relationship)
Dependent

Contact vs Dependent
Spouse & Child both are contacts.
Spouse is not covered in any plan but child is covered, so child is dependent.

Employee, Pending Worker, Contingent Worker, Retiree

Electability is subset of Eligibility.

Eligibility depends on Indicative Data. (Can depend on Life Event: rare Scenario)
Electibility Depends on Life Events.

Coverage => Benefit Amount

Usually Medical, Dental, Vision all health plan do not have coverage amount.
(We can configure if needed).
Life Insurance does.

Premium = Employer Contribution + Employee Contribution (Rate)

Premium is 500 charged by insurance carrer, 300 provided by employer i.e. Employer
Contribution and 200 given by employee i.e. Rate.

Coverage: e.g. Sum Assured

Rate and Premium depends on Coverage.
e.g. Rate is 0.002% of Coverage.
e.g. Premium is 0.005% of coverage.

Data

a. Indicative Date:
Employee Date of Birth, Assignment Details, Salary etc stored in system for
employee. Does not change very often (Personal/Assignment Data)

b. Benificery Data:
Contact become beneficiery when he is covere in any insurance.
c. Derived Date:
Age (This can be calculated based on Date of Birth Stored as indicative data in
system), lentgh of services, Age + LOS etc

d. Enrollmet Data:
Untill you are enrolled in this plan since last two years, you are allowed to
continue. (Historic enrollment Data used to calculate Eligibility and Electibility)

Compensation Object

Active Program, Medical Plan, Cigna Medical A, Option Employee only --> Root is
option, Comp Object
Options are optional, then comp object will be Plan.

Waive Plans:

I dont need any medical plan company offerd by my company. If you are not choosing
anything means you are choosing waive plans.

Temporals:
System, runs within system and identifies all derived factor.

COBRA
Us Legislation Law: Employer 20+ Employee
Consolidated Omnibus Reconcilation Act 1985
COBRA generally requires that group health plans sponsored by employers with 20 or
more employees in the prior year offer employees and their families the opportunity
for a temporary extension of health coverage (called continuation coverage) in
certain instances such as voluntary or involuntary job loss, reduction in the hours
worked, transition between jobs, death, divorce, and other life events. Qualified
individuals may be required to pay the entire premium for coverage up to 102
percent of the cost to the plan.

HIPPA
Health Insurance Portability and Accountability Act 1996
provides data privacy and security provisions for safeguarding medical information