EmpowHR: Section 8 - ESS

Entering/Changing/Canceling Health Benefits Data

To Add/Change/Cancel Health Benefits Data:

1. Select the Employee Self Service menu group.
2. Select the Tasks menu.
3. Select the Payroll Documents component.
4. Select Modify Health Benefits. The Health Benefits page - Elections tab is displayed.

   

5. Complete the fields as follows:

   Field	Description/Instruction
   Empl ID	Populated when the employee signs on to ESS Employee Self-Service.
   SSN	Populated when the employee signs on to ESS Employee Self-Service.
   Health Benefits	Description/Instruction
   *Effective Date	Required field. Populated with the beginning date of the current pay period. This field can be changed by clicking the search icon.
   Pay Period	Populated with the pay period that the document was entered.
   Date Entered	Populated with the date that the document was entered.
   User ID	Populated when the employee signs on to ESS Employee Self-Service.
   Transaction Status	Populated with the current status of the transaction. When the transaction is saved, the status will change.
   Plan Information	Instruction
   Benefit Plan	Enter the health benefit plan.
   Coverage Code	Enter the applicable coverage code for the health benefit plan entered. The literal is displayed to the right of the field.
   Transaction Information	Instruction
   Transaction Code	Select the application action from the drop-down list. The valid values are Add, Change, and Delete.
   Married?	Check this box if the applicant is married.
   Event Code	Select the applicable event from the drop-down list.
   Preferred Telephone Number	Enter the phone number of the applicant.
   Email Address	Enter the email address of the applicant.
   Other Insurance Information	Instruction
   Medicare A	Check this box if applicable.
   Medicare B	Check this box if applicable.
   Medicare D	Check this box if applicable.
   Medicare Claim #	Enter the Medicare claim number if applicable.
   Tricare	Check this box if applicable.
   *Other Insurance	Required field. Select whether or not the applicant has other insurance from the drop-down list.
   FEHB	Check this box if the applicant already has FEHB Federal Employees Health Benefits coverage.
   Other Insurance Name	Enter the private insurance name if the applicant has additional insurance.
   Policy Number	Enter the policy number if the applicant has additional insurance.
   Event Date	Enter the event date or select a date from the calendar icon.
   Date Document Signed	Enter the date the insurance document was signed or select a date from the calendar icon.
   Event Change Code	Enter the event change code or select data by clicking the search icon.
   Office Received Date	Enter the date the office received the document or select a date from the calendar icon.
   Personnel Contact Name	Description/Instruction
   *First	Required field. Enter the first name of the personnel contact.
   Middle	Enter the middle name of the personnel contact, if applicable.
   *Last	Required field. Enter the last name of the personnel contact.
   Suffix	Select the applicable suffix, if applicable.
   Authorized Agency Phone Number	Enter the phone number of the personnel contact’s Agency.
   Personnel Office Phone Number	Enter the phone number of the personnel office for the personnel contact.
   Retro collection by NFC	Check this box if applicable.
   Pre-Tax FEHB Premium	Populated with a check. Uncheck if the pre-tax premium is no.
   Temp Employee Pay Full Premium	Defaults to No. Change by selecting data from the drop-down list.

6. Click Health Benefits Form (SF2809) link to complete the Health Benefits form for submission.
7. Click Save.
8. Click the Dependents link at the bottom of the page. The Health Benefits page - Dependents tab is displayed.

   OR

   Select the Dependents tab at the top of the page. The Health Benefits page - Dependents tab is displayed.

   

9. Complete the fields as follows:

   Field	Description/Instruction
   Empl Id	Populated when the employee signs on to ESS Employee Self-Service.
   SSN	Populated when the employee signs on to ESS Employee Self-Service.
   Coverage	Description/Instruction
   Effective Date	Populated with the beginning date of the current pay period. This field can be changed by clicking the search icon.
   Date Entered	Populated with the date that the document was entered.
   User ID	Populated when the employee signs on to ESS Employee Self-Service.
   Transaction Status	Populated with the current status of the transaction. When the transaction is saved, the status will change.
   Benefit Plan	Populated from the Elections tab.
   Coverage Code	Populated from the Elections tab.
   Dependents Name	Instruction
   *First	Required field. Enter the first name of the personnel contact.
   Middle	Enter the middle name of the personnel contact, if applicable.
   *Last	Required field. Enter the last name of the personnel contact.
   Suffix	Select the suffix, if applicable, from the drop-down list.
   National ID	Enter the SSN Social Security number of the dependent.
   *Date of Birth	Required field. Enter the birth date of the dependent or select a date from the calendar icon.
   *Gender	Required field. Select the gender of the dependent from the drop-down list.
   Preferred Telephone Number	Enter the preferred telephone number.
   Relationship	Select the relationship between the applicant and the dependent from the drop-down list.
   Email Address	Enter the applicable email address.
   Address Information	Instruction
   Address 1	Enter the first line of the dependent’s address.
   Address 2	Enter the second line of the dependent’s address, if applicable.
   Address 3	Enter the third line of the dependent’s address, if applicable.
   City	Enter the city, State, and ZIP Code of the address in each of the appropriate fields.
   Foreign Address Indicator	Check this box if the address is in a foreign country.
   Coverage Information	Instruction
   Medicare A	Check this box, if applicable.
   Medicare B	Check this box, if applicable.
   Medicare D	Check this box, if applicable.
   Medicare Claim #	Enter the Medicare claim number, if applicable.
   Tricare	Check this box, if applicable.
   *Other Insurance	Required field. Select whether or not the applicant has other insurance from the drop-down list.
   FEHB	Check this box if the applicant already has FEHB Federal Employees Health Benefits coverage.
   Other Insurance Name	Enter the name of the other insurance if the applicant has additional insurance.
   Policy Number	Enter the policy number if the applicant has additional insurance.

10. Click the + to add another dependent. If more than two, click the + for each additional dependent.
11. Click Save.