Employee Benefits App in TAM 10.x
GROUP LIFE-HEALTH-DENTAL-VISION-LTD-STD: New Policy Format available in TAM 10.X
Before you can begin using the new policy format available, you must first create the policy types you will be using.
Policy Types Created - A list of the policy types for the new policy format. These are created in UTILITIES/ GENERAL/ POLICY MAINTENANCE/ Install Policy Types. Create policy types for any Employee Benefit that requires more defined information.
Define Benefit Options - Benefit descriptions created to use with Medical Application. These are created under UTILITIES/ GENERAL/ FIELD DEFAULTS/ Define Benefit Options. Create benefit descriptions for Dental, Vision, LTD and STD Applications.
Adding plan benefits in the same sequence on each type of application will create a workflow that will that be consistent on client files.
In this example three policy types have been created for the Medical plan:
- GHM1 - Group Health
- GHM2 - Group Health w/HRA
- GMH3 - Group Health w/HSA
The first policy to install will be the Employer information screen - currently called "Primary Census Application". This application will contain basic Employer information (and will have a more appropriate name in the near future). You will find throughout this presentation, many fields will be used for "other than intended" information. The Policy Type on this example application will be one of the three shown above.
Policy 1001 - Employer Information
- For all benefits that are contained under the Medical policy, subsections are added. If the benefits are all under the same policy number - create a subsection.
- For all benefits that are written with a company different from the Medical plan, a new policy is added. If the benefits have different policy numbers - create a new policy.
Benefit Options under GHM1, GHM2 or GHM3:
Policy 1002 - GHMED2 - Group Health w/HRA (Basic plan benefits)
The Benefit Options are viewed in the drop down box under "Benefit Options" (this is same for all applications):
The following screens are then put in as "Benefit Options" on Policy 1002 and in the same sequence on each client (the order of benefits is determined by you - just be consistent in applying them).
- Screen 1 PREV
- Screen 2 Urgent Care etc
- Screen 3 Therapy
- Screen 4 Mental / SA
- Screen 5 Vision –IF it is a benefit under Medical Plan – not separate benefit.
- Screen 6 Life – Included in Medical Plan – not separate benefit
- Screen 7 Medical Rates (medical rates only) - This example is for Composite rates.
- Screen 8 Group Rates ( all products and total Monthly Premium)
- Screen 9 HRA Contributions – if HRA is part of plan. HRA Benefit Options can be created to reflect how the HRA is administered - such as GHHRA1 could indicate "1st Dollar" and will be displayed in the "Option" description as "HRA-1st Dollar".
Remarks Screen: Lifetime Maximum and New Hire Effective Date of Coverage information located here. Remarks Screen will be the area to put information if there is not a field on any of the other screens that accommodate it. Hopefully in the next TAM update there will be more areas for details.
Policy 1003- GDEN1 (general Group Dental plan benefits) (Or i.e. Policy 2001 if not included in the Medical plan)
Benefit Options under GDEN:
- Screen 1 DEN1 (Dental w/o Ortho) or DEN2 (Dental w/Ortho)
- Screen 2 DEN 3 – Prevent, Basic, Major
- Screen 3 DEN 4 – Peri, Endo, Oral
- Screen 4 DEN 5 – Dental rates
Policy 1004 - GVIS1 (general Group Vision plan benefits) (Or i.e. Policy 3001 if plan not included in the Medical plan)
Remarks Screen: Benefit details for Frames, Lenses, Contacts etc.
- Policy 1005 GLTD1 (general Group LTD plan benefits)- Long Term Disability
- (Or i.e. Policy 4001 if plan not included in the Medical plan) – See List of screens
- Policy 1006 GSTD1 (general Group STD plan benefits)- Short Term Disability
- (Or i.e. Policy 5001 if plan not included in the Medical plan) – See List of screens
- GRPL1 (general Group Life Insurance plan benefits) - (no screen shots available)
- (Or i.e Policy 6001 if plan not included in the Medical plan) - Life benefits separate from Life offered in Medical Plan
Keep in mind the Employee Benefits Module is in it's infancy in TAM. Please send in enhancement requests to Applied when you identify an area that could be improved and indicate what is needed to make it more functional.
The information contained here is meant to be a "road map" to help anyone who wants to set up this area in TAM and to provide ideas on how to get started. You may find better ways of implementing areas used in your agency. There is no right or wrong way to set up these files. It is what works for you. Many of the fields in the screen shots in this Wiki have been updated or added to as I have processed the renewals of files and found additional information to be useful. Remember....this is just a "starter kit"....make it your own.
This process can also be used for Individual Life and Health/Dental/Vision policies.