Using Health Insurance Coverage Codes and Relationships in HRS
Overview
When enrolling employees into benefits plans, or updating those benefits plans through On-Demand, knowing the appropriate Coverage Code values for each situation is critical. Coverage Codes affect health premiums, coverage level such as employee + spouse/DP, employee + children, family, tax dependents, and non-tax dependents. This documents shows which Coverage Code to select for certain years and time-frames.Process Considerations:
- Coverage Codes have changed over time. Please be sure to reference the correct Coverage Code list for the time period you are working in.
You may click on the links below to navigate directly to a section:
Coverage Code Current Reference Sheet:
Dependent Relationships
For Benefit purposes, these are the defined relationships which qualify someone for insurance according to insurance plan rules. Some dependents are not eligible for benefits and cannot be enrolled. Please see table for benefit eligible and non-eligible dependents. Adding and Updating Dependents in HRS
Examples of Coverage Codes
1. 4/10/2011 Coverage Begin Date is using Coverage Codes from spreadsheet 4-10-2011 to 07-02-2011. Coverage Code below is 27. It is using 27 for employee + spouse (tax dependent)
2. 01/01/2015 Coverage Begin Date is using Coverage Codes from spreadsheet 11-02-2014 to Present. Coverage Code below is 16. It is using 16 for employee + spouse (tax dependent)
3. Coverage Codes are selected in On-Demand via ADM Event when selecting Health Benefit election.
Coverage Code Current Reference Sheet:
Coverage Code Historical Reference Sheets:
Dependent Relationships
For Benefit purposes, these are the defined relationships which qualify someone for insurance according to insurance plan rules. Some dependents are not eligible for benefits and cannot be enrolled. Please see table for benefit eligible and non-eligible dependents. Adding and Updating Dependents in HRS The UW has defined the following relationships:
| Relationship to Employee | Eligible for Insurance? |
| Adult Child | No |
| Employee | Yes |
| Spouse | Yes |
| Child (as of 10/2/2017 ) | Yes |
| Stepchild (as of 10/2/2017) | Yes |
| Legal Ward (as of 10/2/2017) | Yes |
| Grandchild | Yes |
| Child Non Tax Dependent (no longer used as of 10/2/2017) |
No |
| Child Tax Dependent (no longer used as of 10/2/2017) | No |
| DP Child Non Tax Dependent (no longer used as of 1/1/2018) | No |
| DP Child Tax Dependent (no longer used as of 1/1/2018) | No |
| Dom Partner Non Tax Dependent (no longer used as of 1/1/2018) | No |
| Dom Partner Tax Dependent (no longer used as of 1/1/2018) | No |
| Emergency Contact | No |
| ExDomestic Partner | No |
| ExSpouse | No |
| Legal Ward Non Tax Dependent (no longer used as of 10/2/2017) | No |
| Legal Ward Tax Dependent (no longer used as of 10/2/2017) | No |
| Qualified Stepchild (no longer used as of 10/2/2017) | No |
| Stepchild Non Tax Dependent (no longer used as of 10/2/2017) | No |
Additional Resources
Related KBs:
- Reprocessing Events Using On Demand Event Maintenance in HRS
- Deleting and Voiding Events Using On Demand Event Maintenance in HRS
- Adding Events to the BAS Activity Table in HRS
- Review Benefit Enrollments in HRS
- Enrolling, Changing, or Canceling Coverage Using On Demand Event Maintenance in HRS
- Overview of Enrollment Codes and Reasons Job Aid for HRS
- Adding and Updating Dependents in HRS
- Plan Types, Benefit Plans, and Payroll Deductions Job Aid in HRS
Related Links: