Benefit and Rate Dependencies

Overview

Benefit dependencies are constraints that define relationships between different benefits and their coverage amounts. They ensure that certain enrollment rules are enforced when employees select their benefits, maintaining compliance with insurance regulations and plan designs. These dependencies can be created using the Add Benefit Dependencies to a Benefit endpoint.

Types of Dependencies

The system supports two categories of dependencies:

1. Benefit Dependencies
   Constraints that apply across different benefit types (e.g., you must enroll in a High Deductible Health Plan to be eligible for an HSA).
2. Rate Dependencies
   Constraints that apply to coverage amounts within rate packages (e.g., a spouse can only elect coverage up to 50% of the employee's selected coverage).

Dependency Options

must_enroll_in

Definition: For every benefit listed in dependentBenefits, ALL must be enrolled in.
Example: To enroll in an HSA, you must enroll in a High Deductible Health Plan (HDHP).
Logic: If there are 5 dependent benefits listed, all 5 must be selected by the employee.

{
  "type": "must_enroll_in",
  "dependentBenefits": ["hdhp-benefit-id"],
  "dependentBenefitsExternal": ["HDHP-2024"]
}

must_enroll_in_one_of

Definition: For all benefits listed in dependentBenefits, AT LEAST ONE must be enrolled in.
Example: To enroll in a Dependent Care FSA, you must enroll in at least one medical plan option.
Logic: If there are 5 dependent benefits listed, only 1 must be selected by the employee.

{
  "type": "must_enroll_in_one_of",
  "dependentBenefits": ["medical-plan-a", "medical-plan-b", "medical-plan-c"]
}

must_not_enroll_in

Definition: For every benefit listed in dependentBenefits, NONE of them must be enrolled in.
Example: You cannot enroll in both an HSA and a traditional FSA Medical account.
Logic: If there are 5 dependent benefits listed, all 5 must NOT be selected by the employee.

{
  "type": "must_not_enroll_in",
  "dependentBenefits": ["fsa-medical-id"],
  "dependentBenefitsExternal": ["FSA-MED-2024"]
}

must_not_enroll_in_one_of

Definition: For all benefits listed in dependentBenefits, AT LEAST ONE cannot be enrolled in.
Example: You cannot enroll in more than one life insurance plan from a specific category.
Logic: If there are 5 dependent benefits listed, at least 1 must NOT be selected by the employee.

{
  "type": "must_not_enroll_in_one_of",
  "dependentBenefits": ["life-plan-a", "life-plan-b", "life-plan-c"]
}