Setup Considerations: Critical Illness Insurance Plans
You can use this topic to help make decisions when planning your configuration and use of critical illness plans. It explains:
- Why to set it up.
- How it fits into the rest of Workday.
- Downstream impacts and cross-product interactions.
- Security requirements and business process configurations.
- Questions and limitations to consider before implementation.
Refer to detailed task instructions for full configuration details.
What It Is
Workday doesn't provide a benefit plan type for critical illness coverage, so you can select from these plan types:
- Insurance
- Additional Benefits
- Health Care
Each plan type enables you to manage enrollments in critical illness plans, but each has important administrative challenges to consider. You select a plan type for your critical illness plans, depending on:
- The critical illness plan design.
- The rate structure.
You also select a plan type depending on what you want to do with the critical illness information:
- Report internally within the company.
- Send the plans to the benefit provider through a benefit connector or a custom integration.
- Send plan information to the benefit provider manually. Example: Uploading the information through a website.
Before you set up a critical illness plan in Workday Benefits, you must consider how you’ll send plan information to your benefits provider. The choices you make while configuring benefit plans determine the information available to send to your provider.
You can create plans that capture the coverage amount for each coverage target, based on whether you use:
- Individual coverage rates.
- Multiple coverage targets.
- Tiered rate bands.
Business Benefits
Selecting the correct plan type before setting up critical illness plans helps:
- Avoid creating a plan that doesn't address your needs and in the wrong format for the benefits provider.
- Deliver the right information to benefit providers through custom or Cloud Connect for Benefits integrations.
Use Cases
- You use individual rates for employees.
- You have multiple rate bands.
- You use age bands.
- You have a vendor not covered by a CCB and use custom integration.
Questions to Consider
Question | Considerations |
|---|---|
What critical illness plan information do you need to give to your benefit provider? | Most benefit providers require specific data elements and reporting formats to establish enrollment participation and coverage amounts. They might:
|
What plan type best captures the information that your vendor requires? | Typically, we recommend the Insurance plan type. Each plan type provides different configuration options. Contact your Integrations Consultant to determine what data and format that they need. |
How many rate bands should you have? | Consider which employee and dependent demographic data determines these rates bands. Examples: Age, dependents, or beneficiaries. |
Recommendations
Plan Type | Recommended For | Considerations |
|---|---|---|
Insurance |
| Recommended for most employers because you can define specific coverage targets and coverage amounts. You can also provide demographic data for dependents. This plan type:
|
Additional Benefits | Individual rate plans. | You can create critical illness plans with different coverage targets and amounts, without creating separate plans for each coverage target.
You can’t easily add age bands, and you can't provide the demographic information required for dependents. |
Health Care |
| Recommended only if the benefit provider or integration vendor asks for tiered coverage, which Insurance plans can provide.
Supports age bands. Health Care plans don’t capture coverage amounts, making it difficult for downstream applications and integrations to display and report coverage. |
Requirements
- Complete the prerequisites required for benefits plans.
- Request the file specification from your benefit provider so that you can familiarize yourself with their data requirements. The plan setup might need to accommodate:
- Coverage start dates.
- Coverage amounts for the employee, spouse, or dependents.
- Demographic information for spouse or dependents. Example: Name, date of birth, and social security number as identifiers.
- Cloud Connect for Benefits integrations: Compare the data requirements for your benefit provider with the output options provided by the integration.
- Create a custom integration if you select a plan type other than Insurance.
- Set up integrations with third-party vendors.
Limitations
No impact.Tenant
No impact.
Security
Domains | Considerations |
|---|---|
Set Up: Benefits domain in the Benefits functional area. | Users secured to this domain can create benefit plans. |
Manage: Benefits for Organizations domain in the Benefits functional area. | Users secured to this domain can manage individual benefit rates. |
Business Processes
No impact.
Reporting
No impact.
Integrations
Workday Cloud Connect for Benefits integrations require an Insurance plan type for critical illness plans. If you don't use Workday-provided integrations, you need to create a custom integration.
When using Cloud Connect for Benefits for critical illness plans, contact your Integration Consultant to ensure that the integration can process the critical illness plan information correctly.
The Cloud Connect for Benefits or custom integrations typically require:
- Subscriber data.
- Enrollment data.
- Compensation data.
- Coverage information.
- Beneficiary information.
- Dependent information.
Connections and Touchpoints
Critical illness plans interact with these parts of Workday:
- Enrollment information.
- Cloud Connect for Benefits.
- Deduction payments.
- Insurance plans.
- Health care plans.
- Additional benefit plans.