ProcessEligibility

Process Eligibility

Minor Business Rule

Object Name: N0800038

Parent DLL: CHRM

Location: Client/Server

Language: NER

Functional Description

Purpose
The Named ER processes eligibility for either a newly elected plan or retests eligibility for a
currently enrolled plan.
Setup Notes and Prerequisites
Current Enrollment parameters are required if retesting eligibility for a currently enrolled plan.
If the current enrollment is to be closed out,  because of change of enrollment status resulting from
the retest, or change of amount or rate, a new enrollment will be created and the new enrollment
parameters will be passed back.  Otherwise, there will be no new enrollment parameters passed back.  If
processing eligibility for newly elected plan or plan option, a new enrollment record will be created and
the new enrollment parameters will be passed back.
Special Logic

Technical Specification
FetchSingle F060116 by key, mnAddressNumber, retrieving EmployeeBenefitGroup and
                EmployeeBenefitStatus
If the fetch F060116 is successful

    //Look for enrollment parameter record (F08392) //
    Call Named ER, "Retrieve Enrollment Parameter" (N0800036), passing in szPlanId,
              EmployeeBenefitStatus, szCurrentEnrollmentStatus, Valid Plan of 'Y', and returning
fields from the
              table, F08392 and an EnrollmentParmRecordFoundFlag to indicate whether an enrollment
parameter is
              found.         //Fields from F08392 are returned to variables, the names ending with
xxxxxxxxXF08392//

    //If enrollment parameter record is not found, set default whether to perform initial or
continuing eligibility
      test//
    If EnrollmentParmRecordFoundFlag <> 1
         ActiveFlag = substr(szCurrentEnrollmentStatus,0,1)
         // If employee is currently and actively enrolled in plan, test continuing eligibility.
Otherwise, perform
            initial eligibility test//
         If jdCurrentEnrollmentDate<> 0 and ActiveFlag = 'A'
              EligibilityCheckF08392 = 'C'
         Else
              EligibilityCheckF08392 = 'I'
         End If

         //Initialize all other enrollment parameters//
        PreviousEnrollmentF08392 = ' '
        ManualCheckF08392 = ' '
        EnrollStatusEndF08392 = ' '
         TerminationCodeF08392 = ' '

    End If    //End of if EnrollmentParmRecordFoundFlag <> 1//

    //Set the date to use to check for previous enrollment//
    If jdCurrentEnrollmentDate <> 0
         DateToUse = jdCurrentEnrollmentDate
    Else
         DateToUse = jdDateEffectiveRates
    End If

    //Check to see if employee was previously eligible if requested//
    Set PreviousEligibleFlag = 'N'
    If PreviousEnrollmentF08392 <> Blank
        //Process through the enrollment table, F08330 to find previous enrollment, if any//
       Select F08330 by key, mnAddressNumber, szPlanId
       Set ReadF08330Flag = '1'
       While file operation is successful and ReadF08330Flag = '1'
              FetchNext F08330, retrieving EligibleDateF08330
              If fetchnext F08330 is successful and ElgibleDateF08330 < DateToUse
                        PreviousEligibleFlag = 'Y'
                        ReadF08330Flag = '0'
              End If
        End While
    End If  //End of If PreviousEnrollmentF08392 <> Blank//

    //Determine which enrollment parameter to use, whether it would be the first set or second set//
    If PrevousEnrollmentF08392 <> PreviousEligibleFlag and PreviousEnrollmentF08392 <> Blank
         EligibilityCodeToUse = EligibilityCheck1F08392
         TermCodeToUse         = TerminationCode1F08392
         ManualReviewToUse   = ManualCheck1F08392
         EnrollStatusEndToUse = EnrollEndStatus1F08392
    Else
         EligibilityCodeToUse = EligibilityCheck2F08392
         TermCodeToUse         = TerminationCode2F08392
         ManualReviewToUse   = ManualCheck2F08392
         EnrollStatusEndToUse = EnrollEndStatus2F08392
    End If

    //Set ManualReview Flag and error code//
    If ManualReviewToUse = 'Y'
            cManualReviewFlag = '1'
            szErrorCode = '2224'
    Else
            CManualReviewFlag = ' '
    End If

    //Validate the Plan//
    FetchSingle F08320 by key, szPlanId and returning EligibilityTable1F08320,
EligibilityTable2F08320 and
         PreRequisitePlanF08320
    If the fetchsingle is unsuccessful
         szErrorCode = '2312'
    End If

    //Validate plan option//
    If szErrorCode <> Blank and szPlanAdditionalOption <> Blank
         FetchSingle F083202 by keys, szPlanId, szPlanAdditionalOption  and returning
ValidOptionFlagF083202
         If fetchsingle is not successful or ValidOptionFlagF083202 = 'N'
              szErrorCode = 2312'
         End If
    End If

    //Determine which eligibility Table to test for eligibility//
    If szErrorCode <> Blank
         If EligibiltiyCodeToUse <> Blank

              If EligibilityCodeToUse = 'I'
                   EligibilityTableToUse = EligibilityTable1F08320
              Else
                   If  EligibilityCodeToUse = 'C'
                        EligibilityTableToUse = EligibilityTable2F08320
                   Endif
              End If

              //Validate the eligibility Table to Use//
              Select F08390, by key, EligibilityTableToUse
              If select operation is not successful
                   szErrorCode = '2335'
              Else
                   FetchNext F08390, retrieving EligibleStatusF08390, InEligibleStatusF08390,
                      EnrollmentCodeF08390 and TerminationCodeF08390
                   If fetchnext is not successful
                        szErrorCode = '2335'
                   End If
              End If

              //Determine Employee Eligibility//
              Call Named ER "Determine Employee Eligibility Server", passing in mnAddressNumber,
szPlanId,
                   jdDateEffectiveRates and EligibilityCodeToUse and returning
cServiceRequirementFlag,
                   cAgeRequirementFlag, and cHoursRequirementFlag

              //Check Prerequisite Plan//
              If PreRequisitePlanF08320 <> Blank
                   //If caching is used, check whether the prerequisite plan is in the "Plan Status"
Enrollment Cache//
                  If F08330EditLineCacheJobN <> 0
                        Trim any trailing blank off PreRequisitePlanF08330
                        Locate PreRequisitePlanF08330 from cache, returning the PlanStatusCode  //
Call  Plan Status

                                              Cache//
                        // If plan is in cache, check if the plan status is 'A' If it is,
PreRequisite Requirement is met//
                        If Error returning from BSFN = Blank
                             If PlanStatusCode = 'A'
                                  cPreRequisiteRequirementFlag = ' '
                             Else
                                  cPreRequisiteRequirementFlag = '1'
                             End If

                        Else   //Else plan is not in cache//
                             Call Named ER, "Retrieve Employee Current Enrollment", passing in,
mnAddressNumber,
                                   PreRequisitePlanF08320, jdDateEffectiveRates and returning the
enrollment status
                                   (PreRequisiteEnrollStatus) and a flag (PreRequisiteEnrollFlag) to
indicate enrollment is
                                   found

                                  ActiveFlag = substr (PreRequisiteEnrollStatus, 0,1)
                                  If PreRequisiteEnrollFlag = '1' and ActiveFlag = 'A'
                                       PlanStatusCode = 'A'
                                       cPreRequisiteRequirementFlag = ' '
                                  Else
                                       PlanStatusCode = ' '
                                       cPreRequisiteRequirementFlag = '1'
                                  End If   //End of if PreRequisteEnrollFlag = '1' and  ActiveFlag =
'A'//

                                  Write PreRequisite plan to Cache
                             End If   //End of if error returning from BSFN = Blank//

                   Else   //Else caching is not used//
                        Call Named ER, "Retrieve Employee Current Enrollment", passing in,
mnAddressNumber,
                                  PreRequisitePlanF08320, jdDateEffectiveRates and returning the
enrollment status
                                  (PreRequisiteEnrollStatus) and a flag (PreRequisiteEnrollFlag) to
indicate enrollment is
                                  found

                        ActiveFlag = substr (PreRequisiteEnrollStatus, 0,1)
                        If PreRequisiteEnrollFlag = '1' and ActiveFlag = 'A'
                             cPreRequisiteRequirementFlag = ' '
                        Else
                             cPreRequisiteRequirementFlag = '1'
                        End If   //End of if PreRequisiteEnrollFlag = '1' and  ActiveFlag = 'A'//

                   End If  //End of if F08330EditLineCacheJobN <> 0//
              End If   //End of if Prerequisite Plan <> Blank //

              //Determine Date by Date Code//
              If cManualReviewFlag <>'1'
                   // If pass eligibility, use eligible status and enrollment code.  Otherwise, use
ineligible status and
                      terminationcode//
                   If cAgeRequirmentFlag, cServiceRequirementFlag, cHoursRequirementFlag and
                       cPreRequisiteRequirementFlag are all blank
                        DateCodeToUse = EnrollmentCodeF08390
                        NewEnrollmentStatus = EligibleStatusF08390
                   Else
                        DateCodeToUse = TerminationCodeF08390
                        NewEnrollmentStatus = InEligibleStatusF08390
                   End If

                   // If status has not change, do not find date for date code, unless change
amount/rate//
                   If (szCurrentEnrollmentStatus <> NewEnrollmentStatus) OR
                       (szCurrentEnrollmentStatus = NewEnrollmentStatus and cActionCode = 'C')
                        Call Named ER "Determine Date by Date Code" (N0800039), passing in
DateCodeToUse,
                              jdDateEffectiveRates, mnAddressNumber and returning the
DeterminedBeginDate and
                              szErrorCode.

                        //Error if determined begin date is zero//
                        If DeterminedBeginDate = 0
                             szErrorCode = 2336'
                        End If

                        //If current enrollment parameters are passed in, determine the current
enrollment end date
                          which is the day prior to the determined begin date.  If current end date <
current enrollment,
                          issue error//
                        If jdCurrentEnrollmentDate <> 0
                             WorkEndDate = add_days(DeterminedBeginDate, -1)
                             If WorkEndDate < jdCurrentEnrollment
                                  szErrorCode = '2337'
                             End If
                        End If

                         //If the date to begin new enrollment record is the same as a previous
identical enrollment ended
                           with a  mistaken enrollment status, do not enrollment//
                        If szErrorCode = Blank
                             Select F08330 by keys, mnAddressNumber, szPlanId, and
szPlanAdditionalOption
                             While the file operation is successful and szErrorCode = ' '
                                  FetchNext F08330, retrieving EnrollmentDateF08330,
EnrollmentEndStatusF08330
                                  If fetchnext F08330 is successful
                                       MistakenEnrollmentFlag = substr(EnrollmentEndStatusF08330,0,1)
                                       If DeterminedBeginDate = EnrollmentDateF08330 and
MistakenEnrollmentFlag = 'X'
                                            szErrorCode = '2432'
                                       End If //End of if determinedbegindate =
enrollmentdatef08330'85'85.//
                                  End If //End of if fetchnextF08330 is successful//
                             End While
                        End If  //End of if szErrorCode = blank//
                   End If   //End of if CurrentEnrollmentStatus <> NewEnrollmentStatus or
'85'85'85'85'85'85.//
              End If   //End of if cManualReviewFlag <> '1'//

         Else   //Else EligibilityCodeToUse = Blank, check other parameters//
              If cManualReviewFlag <> '1'

                   //Process

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Parameter Name	Data Item	Data Type	Req/Opt	I/O/Both
jdDateEffectiveRates	EFT	JDEDATE	REQ	INPUT
The date that identifies when a date is first valid. The effective date is used generically. It can be a lease effective date, a price or cost effective date, a currency effective date, a tax rate effective date, or whatever is appropriate.
mnAddressNumber	AN8	MATH_NUMERIC	REQ	INPUT
A number that identifies an entry in the Address Book system, such as employee, applicant, participant, customer, supplier, tenant, or location.
szPlanId	PLAN	char	REQ	INPUT
An abbreviation or number that identifies a specific employee benefit. Examples are: o Employee Health Insurance o Accidental Death and Dismemberment o Health Club Expense Reimbursement o Employee Stock Appreciation Rights A benefit plan typically is associated with a deduction, benefit, or accrual. For example, a medical plan is a benefit that might also require a deduction to withhold premiums from an employee's pay.
szPlanAdditionalOption	AOPT	char	NONE	NONE
A code that identifies any additional options available for a benefit plan that have been defined in the Plan Additional Options table (F083202). Note: Additional options must have the same provider, policy number, and enrollment and eligibility rules as the benefit plan to which they are associated.
jdCurrentEligibleDate	DELG	JDEDATE	NONE	NONE
The date on which the employee is eligible to enroll in the benefit plan. This date is not necessarily the date that the employee begins participating in the plan. For example: The XYZ Company requires that employees work for the company for six months before they are eligible to participate in the 401(k) plan. Employees can enroll in 401(k) two times per year, on January 1 and July 1. Therefore, an employee who begins working for XYZ Company on 03/01/05 has an eligibility date of 01/01/06. The eligibility date is the date on which the employee becomes eligible, provided that eligibility continues. If the employee changes to a non-eligible status, the eligibility date on the new record is set to blank.
jdCurrentEnrollmentDate	EFT	JDEDATE	NONE	NONE
The date that identifies when a date is first valid. The effective date is used generically. It can be a lease effective date, a price or cost effective date, a currency effective date, a tax rate effective date, or whatever is appropriate.
szCurrentEnrollmentStatus	XDFS	char	NONE	NONE
A code that indicates the status of an employee's enrollment in a plan. It is a user defined code (08/ES), and you must use the following restrictions for the definitions: o All statuses indicating active participation in a plan must begin with the letter A. o All statuses indicating an ending status that does not result in a new enrollment (such as a termination) must have the letter X in the first position of Description 2 (data item DL02), General User Defined Codes form. o A status beginning with the letter X, when used as an ending status, represents a mistaken enrollment. No employee DBA instructions are written. o An asterisk (*) indicates all statuses not otherwise specified.
jdCurrentParticipationDate	DPTC	JDEDATE	NONE	NONE
The date on which the employee begins participating in the plan for the specified enrollment period. For example: The XYZ Company requires that employees work for the company for six months before they are eligible to participate in the 401(k) plan. Employees can enroll in 401(k) two times per year, on January 1 and July 1. An employee who begins working for XYZ Company on 03/01/05 is eligible to participate in the plan on 01/01/06. However, if the employee does not enroll in the plan until 07/01/06, the employee's participation date is 07/01/06. The participation date is the first date on which the employee begins participating in the plan, provided that the employee continues to participate. When participation stops, the participation date on the new record is set to blank. If the employee has a break in eligibility, the participation date is the date that participation began for the latest enrollment period.
szCurrentEnrollmentEndStatus	XEST	char	NONE	NONE
A code that indicates the ending status of an employee's enrollment in a plan. This status represents the reason for ending the old enrollment and is used as the beginning status of any resulting new enrollment. You can define this code using user defined code table 08/ES. See data item XDFS (Status - Enrollment) for restrictions on the allowed values. Note: An ending status that begins with the letter X represents a mistaken enrollment.
jdCurrentEnrollmentEndDate	EFTE	JDEDATE	NONE	NONE
The date on which the item, transaction, or table becomes inactive, or through which you want transactions to appear. This field is used generically throughout the system. It could be a lease effective date, a price or cost effective date, a currency effective date, a tax rate effective date, or whatever is appropriate.
jdCurrentDBAEndDate	DTDE	JDEDATE	NONE	NONE
The ending date on the employee's DBA instruction record (F06106) for this enrollment. In most cases, this is the same as the ending effective date of the enrollment. However, it can be later than the ending effective date if the enrollment is changed retroactively. Only active enrollment records have a value in this field since they are the only enrollment records that result in payroll deductions, benefits, or accruals. Active records have a beginning status that starts with A.
jdNewEligibleDate	DELG	JDEDATE	NONE	NONE
The date on which the employee is eligible to enroll in the benefit plan. This date is not necessarily the date that the employee begins participating in the plan. For example: The XYZ Company requires that employees work for the company for six months before they are eligible to participate in the 401(k) plan. Employees can enroll in 401(k) two times per year, on January 1 and July 1. Therefore, an employee who begins working for XYZ Company on 03/01/05 has an eligibility date of 01/01/06. The eligibility date is the date on which the employee becomes eligible, provided that eligibility continues. If the employee changes to a non-eligible status, the eligibility date on the new record is set to blank.
jdNewEnrollmentDate	EFT	JDEDATE	NONE	NONE
The date that identifies when a date is first valid. The effective date is used generically. It can be a lease effective date, a price or cost effective date, a currency effective date, a tax rate effective date, or whatever is appropriate.
szNewEnrollmentStatus	XDFS	char	NONE	NONE
A code that indicates the status of an employee's enrollment in a plan. It is a user defined code (08/ES), and you must use the following restrictions for the definitions: o All statuses indicating active participation in a plan must begin with the letter A. o All statuses indicating an ending status that does not result in a new enrollment (such as a termination) must have the letter X in the first position of Description 2 (data item DL02), General User Defined Codes form. o A status beginning with the letter X, when used as an ending status, represents a mistaken enrollment. No employee DBA instructions are written. o An asterisk (*) indicates all statuses not otherwise specified.
jdNewParticipationDate	DPTC	JDEDATE	NONE	NONE
The date on which the employee begins participating in the plan for the specified enrollment period. For example: The XYZ Company requires that employees work for the company for six months before they are eligible to participate in the 401(k) plan. Employees can enroll in 401(k) two times per year, on January 1 and July 1. An employee who begins working for XYZ Company on 03/01/05 is eligible to participate in the plan on 01/01/06. However, if the employee does not enroll in the plan until 07/01/06, the employee's participation date is 07/01/06. The participation date is the first date on which the employee begins participating in the plan, provided that the employee continues to participate. When participation stops, the participation date on the new record is set to blank. If the employee has a break in eligibility, the participation date is the date that participation began for the latest enrollment period.
jdNewDBABeginDate	DTDB	JDEDATE	NONE	NONE
The beginning date on the employee's DBA instruction record (F06106) for this enrollment. In most cases, this is the same as the beginning effective date of the enrollment. However, it can be later than the beginning effective date if the enrollment is changed retroactively. Only active enrollment records have a value in this field since they are the only enrollment records that result in payroll deductions, benefits, or accruals. Active records have a beginning status that starts with A.
cAgeRequirementFlag	EV02	char	NONE	NONE
An option that specifies the type of processing for an event.
cServiceRequirementFlag	EV03	char	NONE	NONE
A radio button that specifies the level at which trace/track result is to be displayed. Select the Detail to display all transactions except IB, IX, and IZ types. Or, select Derivative Lots Only to display only those transactions that may have created new derivative lot.
cHoursRequirementFlag	EV04	char	NONE	NONE
PeopleSoft event point processing flag 04.
cManualReviewFlag	EV05	char	NONE	NONE
A flag that indicates whether automatic spell check is turned on.
cPreRequisiteRequirementFlag	EV06	char	NONE	NONE
An option that specifies the type of processing for an event.
szErrorCode	VC04A	char	NONE	NONE
This is a generic field used as a work field in Everest.
jdPlanCategoryEndingDate	EFTE	JDEDATE	REQ	INPUT
The date on which the item, transaction, or table becomes inactive, or through which you want transactions to appear. This field is used generically throughout the system. It could be a lease effective date, a price or cost effective date, a currency effective date, a tax rate effective date, or whatever is appropriate.
szDefaultEndingStatus	XEST	char	REQ	INPUT
A code that indicates the ending status of an employee's enrollment in a plan. This status represents the reason for ending the old enrollment and is used as the beginning status of any resulting new enrollment. You can define this code using user defined code table 08/ES. See data item XDFS (Status - Enrollment) for restrictions on the allowed values. Note: An ending status that begins with the letter X represents a mistaken enrollment.
jdNewEnrollmentEndDate	EFTE	JDEDATE	NONE	NONE
The date on which the item, transaction, or table becomes inactive, or through which you want transactions to appear. This field is used generically throughout the system. It could be a lease effective date, a price or cost effective date, a currency effective date, a tax rate effective date, or whatever is appropriate.
jdNewDBAEndDate	DTDE	JDEDATE	NONE	NONE
The ending date on the employee's DBA instruction record (F06106) for this enrollment. In most cases, this is the same as the ending effective date of the enrollment. However, it can be later than the ending effective date if the enrollment is changed retroactively. Only active enrollment records have a value in this field since they are the only enrollment records that result in payroll deductions, benefits, or accruals. Active records have a beginning status that starts with A.
szNewEnrollmentEndStatus	XEST	char	NONE	NONE
A code that indicates the ending status of an employee's enrollment in a plan. This status represents the reason for ending the old enrollment and is used as the beginning status of any resulting new enrollment. You can define this code using user defined code table 08/ES. See data item XDFS (Status - Enrollment) for restrictions on the allowed values. Note: An ending status that begins with the letter X represents a mistaken enrollment.
cActionCode	EV01	char	NONE	NONE
An option that specifies the type of processing for an event.
szDftEndStatusFromPlanEndDate	XEST	char	REQ	INPUT
A code that indicates the ending status of an employee's enrollment in a plan. This status represents the reason for ending the old enrollment and is used as the beginning status of any resulting new enrollment. You can define this code using user defined code table 08/ES. See data item XDFS (Status - Enrollment) for restrictions on the allowed values. Note: An ending status that begins with the letter X represents a mistaken enrollment.
F08330EditLineCacheJobN	MATH01	MATH_NUMERIC	NONE	INPUT
- - - Good Performance Low Value.
cErrorFlag	VC01A	char	OPT	OUTPUT
This is a generic field used for video constants display.
cResultPrevEligbility	ENRP	char	OPT	OUTPUT
A code that indicates whether the employee was previously eligible for the plan. Valid values are: Blank Do not check for previous eligibility. Y Yes, the employee was previously eligible. N No, the employee was not previously eligible. If the system finds a code in this field, it then searches the detail area for further information.
cResultEligibilityBasis	ELGB	char	OPT	OUTPUT
This field works in conjunction with the Number of Days, Months, Years field and the Date to Follow field to define an enrollment date that is a certain number of days, months, or years after a particular date. For example, if you want the effective date of enrollment to be one year after the employee's original hire date, define these fields as follows: 1. Enter 1 in the Number of Days, Months, Years field. 2. Specify Year for the basis. 3. Enter the user defined code (system 08, type D2) that indicates original hire in the Date to Follow field. When you run an eligibility test, the system searches the Employee Master table for employees who are eligible to enroll in the plan because they meet these requirements.
szResultEligibilityTable	XET	char	OPT	OUTPUT
A code that identifies the specific table of eligibility rules. The rules determine whether the employee is eligible for enrollment in a plan.
jdDateDeterminedbyDateCode	EFT	JDEDATE	OPT	OUTPUT
The date that identifies when a date is first valid. The effective date is used generically. It can be a lease effective date, a price or cost effective date, a currency effective date, a tax rate effective date, or whatever is appropriate.
cAdjustDateByDateCodeFlag	EV01	char	OPT	INPUT
An option that specifies the type of processing for an event.
cUserDefinedRequired	EV01	char	OPT	NONE
An option that specifies the type of processing for an event.

ProcessEligibility