Configuring Critical Illness Plans (Volume-Based)

This article includes a walkthrough of how to create a volume-based Critical Illness option for employees and dependents, with details on creating the coverage line, associating a plan, adding rates, building and connecting a deduction, and configuring rules, if applicable.

Visit Configuring Critical Illness Plan (Age-Banded and Tiered) for instructions on how to create a Critical Illness option for employees and dependents for Age-Banded and Tiered Critical Illness Plans.

ADDING A COVERAGE LINE

To add a coverage line for Critical Illness:

1. Navigate to Namely Payroll.

2. Click Enrollment Setup.

3. Click Coverage Line > Add.

See below for an example of an employee coverage line setup for ​a​ typical volume-based Critical Illness Plan: 

See below for an example of a spouse coverage line setup for ​a​ typical volume-based Critical Illness Plan: 

See below for an example of a child coverage line setup for ​a​ typical volume-based Critical Illness Plan: 

ADDING THE CARRIER (IF APPLICABLE)

If this is your first time with a plan from this carrier, you will need to add that carrier to Namely Payroll to be able to associate it with your Critical Illness plan:

1. Click Enrollment Setup > Carrier > Add.

2. Use the dropdown menu to select the carrier.

3. Enter in a custom Carrier Name.

4. Click Save.

CREATING PLANS

To create a Critical Illness plan:

1. After your coverage line has been created, click Plan > Add Plan.

2. Enter the required fields:

• Plan Name

• Start Date

• Child Over Age

• Student Limiting Age

• Premium Adjust Months

3. If the Critical Illness plan has a different waiting period than the class eligibility, use Override Wait Period.

See below for an example of a typical volume-based Critical Illness Plan setup for an employee:

See below for an example of a typical volume-based Critical Illness Plan setup for a spouse:

Note: Switch Age Type to Spouse if rates are based on Spouse age instead of Employee age.

See below for an example of a typical volume-based Critical Illness Plan setup for a child:

TIP:

When adding the Child Critical Illness coverage line and plan, select Level/Class for the Plan Tier to calculate the correct rate. 

ADDING RATES

To add rates once the plan has been created:

1. Use the Coverage Line dropdown to select Critical Illness.

2. Click Edit Rate next to your newly created plan > Add Plan Rates.

3. Fill out the following fields:​​​

• Minimum

• Maximum

• Factor

  • Factor will always be 1 for Volume based Critical Illness plans

1. Complete the Age From and Age To section.

2. Add in the Rate (total premium) > Save.

   • The cost of the volume plan rates will need to be the price per $1000 of coverage.

See below for an example of a typical volume-based Critical Illness rate setup for an employee:

See below for an example of a typical volume-based Critical Illness rate setup for a spouse:

See below for an example of a typical volume-based Critical Illness rate setup for a child:

CREATING A DEDUCTION

To create a deduction and connect it to the newly created Critical Illness plan:

1. In Namely Payroll, click Company > Deductions > Add.

2. Enter the following fields:

• Deduction Type

• Deduction Code

• Deduction Name

• Start Date

• Paid By

See below for an example of a typical volume-based Critical Illness deduction for an employee:

See below for an example of a typical volume-based Critical Illness deduction for a spouse:

See below for an example of a typical volume-based Critical Illness deduction for a child:

Note: in order to attach the deduction to the plan immediately, the start date must be before the current date, or it will not appear in the next steps.

To connect the deduction to the plan itself:

1. After the deduction has been created, go back to Enrollment Setup > Plan.

2. Choose one of the below from the Coverage Line dropdown menu:

• Critical Illness- Employee

• Critical Illness- Spouse

• Critical Illness- Children

1. Attach the deduction by using the dropdown selection from the Deduction field on the plan.

2. Click Save Changes.

ADDING RULES (IF APPLICABLE)

Most Critical Illness plans require enrollment in a medical plan. Some only require a general enrollment in a medical plan of your choosing while others will require enrollment in a plan sponsored by the employer. 

If the employee is required to be enrolled in plan sponsored by the employer, submit a case in the Help Community. A rule will be added on the backend by a service consultant to tie the Medical coverage line to the Critical Illness coverage line.

Generally, a rule stating that the Spouse or Child Plan cannot be elected unless the Employee Plan is elected is implemented since a separate plan is created for an employee, spouse, and child. Rules will need to be added if the Spouse and Child Plan volumes are limited based on the Employee Plan election.