Create Health Care Plans

Set up benefits.

Create benefit coverage types for health care.

Create health care rates. Define rates by:

Age.

Demographic factors.

Length of service.

Percentage of salary.

Percentage of salary plus a flat amount.

Security: Set Up: Benefits
in the Benefits functional area.

You can create a plan for each health care provider. You can have multiple plans, including high-deductible plans. For US employees, you can also configure options for US Medicare and US Affordable Care Act Form 1095-C.

Access the

Create Benefit Plan

task.

From the

Benefit Plan Type

prompt, select Health Care Coverage Plan
.

Select a

Health Care Rate Type

to determine how you map benefit groups with health care rates or plan costs.

Select:

Flat Rate
to configure plan costs for each benefit group.

Calculated Rate
to select a predetermined health care rate. You can create a derived health care rate based on additional criteria that add credits or surcharges for the benefit plan from the

Create Health Care Rate

task.

As you complete the task, consider:

Option	Description
Do Not Use	When selected, Workday appends the Do Not Use label to the benefit plan name and hides it from Benefit Plan configuration prompts, as of the effective date. This check box doesn't hide the benefit plan name from configuration prompts in these tasks and business process: Create or Edit External Payroll Deduction tasks. Create or Edit External Payroll Earning tasks. Review COBRA Eligibility Event business process.
External Plan Description	Create an external URL that Workday displays on the enrollment form.
Worker Plan Eligibility	Select an eligibility rule to limit plan coverage to a subset of workers in the participating benefit group. Example: Limit coverage in the Hourly Employees benefit group to the workers in the state of California. Select an eligibility rule that includes only California workers.
Dependent Plan Eligibility	Select an eligibility rule to limit coverage to a class or category of dependents. Example: Limit coverage to dependents under the age of 27.
Overage Dependent Eligibility	Select the eligibility rule to use in association with the Fair Market Value per Dependent field. This rule enables you to determine who should have imputed income calculated by Workday Payroll or Payroll Interface.
Auto Enroll	Select to enroll employees in a benefit plan automatically. When you select this option, access the Maintain Benefit Coverage Types task. Select the Only One Election check box for the coverage type that the health care plan belongs to. During enrollment, Workday automatically selects Elect for the plan and the employee can't make changes.
High Deductible Health Plan	Select to enable Health Savings Account elections.
Use Individual Rates	Available when if the Health Care Rate Type is Flat Rate. Select to override the employee and employer costs specified on the Manage Individual Rates task.
Reset Individual Rates on Plan Year Begin	Select to update employee and employer costs when the new plan year begins. Workday uses the values defined in the benefit plan. If you don't select this check box, the costs stay the same as the preceding year. Displays during enrollment when you select both: A Health Care Rate Type of Flat Rate . The Use Individual Rates check box.
Currency	Specifies the currency used to calculate the contribution amount for the benefit plan. Select the same currency used by the benefit groups that can enroll in the plan. Consider creating a separate benefit plan for each currency or country. You can only update this field if the Usage Count is zero.
Frequency	Available when the Health Care Rate Type is Flat Rate. Workday uses this frequency in payroll calculations, which might differ from the rate frequency displayed to employees during benefit enrollment.
Derive Coverage Targets	Select to have Workday automatically populate the Coverage targets that display when you view or modify your benefit plans. When you enroll workers in health care plans, Workday selects the Coverage target automatically based on current employee information.
Earnings and Deductions	For Workday Payroll, select: Earning for benefit credits. Employer costs that are taxable to the employee. Required for imputed income. Deduction for pretax and posttax employee costs. The employer costs and benefit surcharges that aren’t taxable to the employee. Workday also uses these deductions for calculated health care rates. You need to specify deductions to ensure that the plans display costs. When using the Payroll Interface for Workday, perform additional setup steps to map earnings and deductions to flexible health care rates. Contact your Integration Consultant for guidance on these setup steps.
Related Articles	Select existing articles related to the health care plan to build a knowledge base. You can link the last published version of an article that you create and publish with the Create Article task to a benefit plan. Workers don't see a link in the benefit plan details. See Steps: Set Up Knowledge Management.

(Optional) Configure options for the US Affordable Care Act Form 1095-C in the

US Affordable Care Act Options

section when you select a Medical
health care type.

(Optional) Configure the

US Medicare Options

section to identify which benefit plans coordinate with Medicare.

Add plan details for your employees so that they can see the specific features of the benefit plan.

As you complete the

Expanded Plan Details

section, consider:

Option	Description
Expanded Plan Details	Select the dental, medical, or vision plan benefit detail. Example: Copay , Coverages , or Office Visits .
Coverage Details	Select the coverage type, level, or benefit detail to display. Example: If you selected Chiropractor for the Expanded Plan Details, you might select In Network as the coverage detail.
Coverage Detail Type	Select the type of coverage. Available options depend on the value in the Coverage Details field and include: Currency Amount Percentage Yes/No Number Months Years
Coverage Detail Value	Enter or select the value for the benefit detail. Example: You select Chiropractor in Expanded Details , Out of Network for Coverage Details , and Yes/No for Coverage Details Type . You can select or clear the check box to indicate whether employees have Chiropractic coverage.
Value Override	Enter text that replaces the value for Coverage Detail Value , such as an email address, phone number, or considerations for the employee.

Configure the

Benefit Rates and Eligibility

grid to map benefit groups to health care rates or plan costs.

As you complete the step consider.

Fair Market Value per Dependent	Flat Rate: Workday Payroll or Payroll Interface uses this value and Over Age Dependent Eligibility to calculate the imputed income.
External Payroll Cost Splits	Flat Rate: If you use an external payroll system to calculate flat rate costs, select: The payroll entity. The corresponding benefit deduction. The cost amount.