The Rules Engine is a powerful tool which is used to drive many components including benefit eligiblity, documents, communications, and data interchange with insurance carriers. Configuring rules can be as simple or complex as needed to support the requirements of the desired action.
Types of Rules:
Only one condition. There are 20 available conditions including: class, division, state, tobacco use, or gender.
- Sample Scenario: Rule targets Maryland, DC, and Virginia employees
- Sample Rule Configuration: State = Maryland, DC, Virginia
- Rule is true if employee address is either Maryland, DC, or Virginia
Tip! Age is greater than 40 and less than 70 sounds complex, but it’s really simple because there is only one condition being evaluated.
More than one condition, where all conditions must be met for rule to be true. Think of this as the *AND* rule.
- Sample scenario: Rule targets Full-Time employees, *AND* living in Maryland, *AND* Male.
- Sample Rule Configuration: Complex Rules where conditions are Class = Full-time AND State = Maryland AND Gender = Male
- Rule is true when all conditions are met.
Tip! If you need to separate your conditions with *OR* instead of *AND* you need to use multiple complex rules.
Multiple Complex Rule:
More than one complex rule, where each rule is evaluated separately. Think of this as the *either/or* rule.
- Sample scenario: Rule targets all Executives *OR* Full-time employees, living in Maryland, who are Male.
- Sample Rule Configuration: Multiple Rules where rule #1 is Class = Executive, and rule #2 is Class = Full-time AND State = Maryland AND Gender = Male
- Rule is true if *EITHER* the conditions of Rule #1 are met, *OR* if the conditions of Rule #2 are met.
- Turn rules on or off with the “Active” check box.
- If you don’t have an *OR* you should be using complex rules
- If an employee's demographics were updated to qualify them for a Dynamic Class, you may need to manually recalculate their eligibility. You may do so from the employee's Benefits Eligibility page and clicking "Recalculate".
Years of Service
As of October 2018, Years of Service has been added as a new Dynamic Class condition and medical model plans can now support contributions based on Years of Service as well as change rules associated with a year of service bracket change.
Conditions that can be configured:
- Equal to
- Less than
- Greater than
- Not equal to
- Less than or equal to
- Greater than or equal to
NOTE: "Between" will include both values. Example: Dynamic class rules are setup for between 9 and 10. Employees in both their 9th and 10th year of service will fall under this dynamic class. If the band is only 1 year of service, just select the "equal to" option. In this case we would say Equal to 9 years.
Tip! The system will only factor in years when determining an employee's years of service.
Example: The employee's effective date is 1/1/2018. An employee was hired 4/1/2017. They have been employed for roughly 1 year and 8 months. The system will ignore the additional 8 months and the employee will be considered to have 1 year of service.
If you have a rule setup for employees greater than 1 year of service, this employee will be overlooked because they are equal to 1 year of service. In this scenario, we would change the rule to greater than or equal to 1 year.
See supplemental article for more information on Rules: https://employeenavigator.zendesk.com/entries/22147966-Rules-Engine-Guidelines-Instructions