When configuring rates the Age Determination option allows the system to calculate employee rates based on carriers' rules. The options available are: 

  • Plan Anniversary

  • Plan Anniversary (Ignore Hire Date)

  • First of the Month

  • End of the Month

  • First of the Year

  • Original Effective Date

  • Current Year - Birth Year


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The most commonly used options are Plan Anniversary and 1st of the Month. Additional information about each option is listed below: 


Plan Anniversary  

  • For ongoing employee enrollments - use this option when the carrier determines an employee’s rate based on his/her age at each renewal. Example: Renewal date is 7/1. Jane Doe has been enrolled since 5/1/2014. Renewal date is 7/1/15. Her birthday is 3/12 and she turned from 33 to 34. Even though she’s one year older in March her new higher rate (for age 34) won’t go into effect until 7/1/15. She’ll continue to pay the current rate (for age 33) until 7/1/15. 


  • For new hires – use this option when the carrier determines an employee's rate based on his/her age as of their benefits effective date. Renewal date is 7/1. John Doe’s birthday is 2/14. The carrier will determine an employee’s rate on his effective date 4/1/15 based on his age on 4/1/15. His medical is effective 4/1/15. John Doe is 45 on 4/1/15. The carrier would calculate his rate based on age 45 from 4/1/15 – 7/1/16 at renewal. Then at 7/1/16 he would be charged the rate as if he was 46. 


Plan Anniversary (Ignore Hire Date)

  • For ongoing employee enrollments - the carrier will determine an employee’s rate based on his/her age at each renewal. Example: Renewal date is 7/1/15. Jane Doe has been enrolled since 5/1/2014. Her birthday is 3/12 and she turned from 33 to 34. Even though she’s one year older in March her new higher rate (for age 34) won’t go into effect until 7/1/15. She’ll continue to pay the current rate (for age 33) until 7/1/15. (This is the same as the “Plan Anniversary example)


  • For new hires – John Doe’s birth day is 2/14. The carrier will determine an employee’s rate on his/her age at the previous renewal – even if the employee was not enrolled at that time. Example: Renewal date is 7/1/15. John Doe is 45 on 4/1/15 when his medical plan is effective.  The carrier would calculate his rate based on age 44 (his age as of the last renewal 7/1/14) from 4/1/15 – 7/1/15 at renewal. Then at 7/1/15 he would be charged the rate as if he was 45.


First of the Month (Age at the First of the Month)

  • This option will rate the employee’s age based on the first of the month. Example: Sally Smith will turn 30 on 5/4. As of 5/1, she would still be charged the 29 year old rate. Her rate would update to the 30 year old rate starting 6/1.  


End of the Month (Age at the End of the Month)

  • This option will rate the employee’s age based on the last day of the month. Example: Sally Smith will turn 30 on 5/4. As of 5/1, she would be charged the 30 year old rate because as of 5/31 she would be 30. Her rate would update to the 30 year old rate starting 5/1.  



First of the Year

  • This option will only change an employee’s rate effective the first of the year, 1/1, regardless of the plan anniversary effective date. 


Original Effective Date

  • This option will always use the employee's Original Effective Date to determine the age for which the rate should be calculated by. The Original Effective Date will be referenced from the Employees > Coverage page. The Original Effective Date can be imported to an employee's record. Please reference the All Inclusive template here for header values.


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Current Year - Birth Year

  • This option will determine an employee's age by taking the current year and subtracting the birth year (example: 2018 - 1980 = 38).