Previous > Configuring Plans > RATES


In the CONTRIBUTION TYPE menu you can choose to enter Employee contributions or Employer contributions. 


In the CONTRIBUTION DETAIL menu choose whether contributions will be entered based on a Tier (composite rates), Table (age rated plans), or Custom format. 


Usually, if plan premiums are entered in the Rates page as a Table RATE TYPE, Table will also be selected as the CONTRIBUTION TYPE on the Contributions page. If plan premiums are entered in the Rates page as a Tier RATE TYPE, Tier will also be selected as the CONTRIBUTION TYPE on the Contributions page. 


The Custom option allows specific contributions to be entered by Table or Tier-Table amount. This would be used when different contributions apply to employees and dependents for different ages. 


Contributions can be entered as either a dollar amount or a percentage. If entering a percentage make sure to enter the % symbol otherwise the system always defaults to $. 



Optional features: 


The Employee > Employer Max ($) and Spouse > Employer Max ($) can be used if the employer pays a percentage of the premium but only up to a maximum $ amount. 


If using a Table rate, the Dependents > Contribution ($/%) field should only be populated if there is one employer contribution applied to the total combined dependent premium, regardless of how many dependents (including the spouse) are enrolled. Individual dependent contribution amounts will not be entered above next to each type of dependent, since the % or $ amount displayed in the Dependents > Contribution ($/%) field will always override any individual contribution amounts and will always be applied to the dependent or combined dependents premium. 


The Dependents option is not commonly used and only needed for more complex contribution models. 


If using a Table rate, the Combined Dependents > Contribution ($/%) field should only be populated if the individual dependent contribution amounts above no longer apply when more than one dependent (including the spouse) is enrolled. The % or $ amount displayed in the Combined Dependents > Contribution ($/%) field will override the individual dependents contributions above only if more than one dependent (including the spouse) is enrolled, and will be applied to the combined dependent premium. The amount in the Combined Dependents  > Contribution ($%) field will be one contribution % or $ that will apply to the total premium of all enrolled dependents. 


*There must be Contribution ($/%) amounts entered next to each type of dependent (Spouse, Child 1, etc.) when the Combined Dependents option is used since the Combined Dependents option will only be applied to the premium if more than one dependent is enrolled. 


*The Combined Dependents option is not commonly used and only needed for more complex contribution models. 


The Dependents > Employer Max ($) or Combined Dependents > Employer Max ($) would apply a maximum employer contribution $ to the Family cost. 


In the below example the employer pays 50% of the total premium applied to all dependents (spouse and children) up to a maximum employer contribution of $300 per month. 




In the CONTRIBUTION TYPE menu, the Base Plan option is used only if there is a Buy-Up or Buy-Down plan situation.


  1. First set employee and employer contributions normally for the base plan. 
  2. Then when creating the Buy-Up plan, select Base Plan Contribution in the rate section to determine that buy-up plan's rates are based on the base plan's rates and contributions.  
  3. An additional drop down which will allow you to select the Base Plan already entered into the system. 
  4. The contributions would be left blank and the system would charge the difference between the base plan and buy-up plan. 

Note: Only choose the Base Plan option if you are in the Buy-Up or Buy-Down plan. 



The employee's contribution will be based on the difference between the base plan and the buy-up plan.


The system is able to support base plan contributions even if the employee is not eligible for the base plan. As an example, an employee outside of California will use the employer contribution towards the California base plan as the contribution towards the out of state plan, even though the employee is not eligible for the buy-up plan. In this scenario, if the base plan includes more than one eligibility with different contribution amounts in each eligibility, EaseCentral will calculate the contribution for the out of state employee based on the first eligibility in the list, Corporate in the example shown below. If this will not calculate the correct contributions, two base plans should be set up and the appropriate buy-up plans should have the appropriate base plan selected. If all employees are eligible for the base plan, there is no need to build separate base plans. Multiple eligibilites will work as expected in this setup.

 

 

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Note: if there is a buy-down plan option where the base plan contribution is greater than the cost of the buy-down plan (spillover), by default any leftover monies will be applied to dependent costs. If spillover SHOULD NOT occur select the APPLY EXTRA AMOUNT TO EMPLOYEE ONLY? option.




Different contributions can be assigned to different Eligibility groups by selecting the appropriate Eligibility option and assigning appropriate contributions to each. If Contribution amounts are the same for each Eligibility group, contributions can be copied from other existing Eligibility options by selecting Copy Contributions. 





Contribution models based on a percent of an employee's salary are supported in EaseCentral. This feature will work with all CONTRIBUTION DETAIL types - Table, Tier, Tier-Tobacco and Custom.


Employers that charge an employee a percentage of their salary to align with ACA affordability rules can enter in the contributions as follows:


On the Contributions tab, set the CONTRIBUTION TYPE as Employer. Enter in the EMPLOYEE MAX PERCENTAGE OF INCOME. Set the Employer contribution as $0. The system will calculate the cost based on the max percentage entered. If the employee has hourly wages entered in their Employee > Employment > Compensation page, EaseCentral will calculate their monthly income by taking the hourly rate and multiplying it by 130 hours (30 hours per week) which uses the IRS definition of a Full-Time employee. 




If there is a set cost not to exceed a specific percentage of income, set the CONTRIBUTION TYPE as Employee. Enter in the employee contribution as well as the EMPLOYEE MAX PERCENTAGE OF INCOME and the system will charge the employee the less expensive amount:




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