Benefits administration

/hcm/benefits (admin tab) is the HR-admin surface for setting up benefits plans, opening + closing enrollment windows, transmitting the ASC X12 834 v005010X220A1 EDI file to carriers, and running the COBRA continuation engine for terminating employees. The platform's frozen IRS limits cover 2025-2027.

TL;DR — Open HCM → Benefits → Admin. Set up plans (medical, dental, vision, FSA, HSA, life, disability, transit, 401(k)). Open an enrollment window. After elections close, generate + transmit the 834 file. COBRA notices auto-prepare on qualifying events.

Before you start

• Have carrier-side plan documents ready — premium per coverage tier, deductible, OOP max, network, eligibility rules.
• Decide the open-enrollment window dates for the workspace.
• For HDHPs: confirm § 223 compliance is built into the plan (deductible meets the IRS limit, etc.).
• For 401(k): know your employer-match policy.

Plan setup

1. 1

   Click "+ New plan"

   Opens the plan-creation form.

2. 2

   Type + carrier

   Medical / dental / vision / FSA / HSA / life / disability / transit / 401(k). Carrier name + plan-ID.

3. 3

   Coverage tiers + premiums

   Employee-only / Employee + spouse / Employee + child(ren) / Family — premiums per period.

4. 4

   Eligibility rules

   Benefits class(es) that can enroll; waiting period; open-enrollment vs new-hire vs life-event applicability.

5. 5

   Pre-tax / post-tax + IRS reference

   For FSA / HSA / transit: IRS limits auto-populate from the frozen 2025-2027 table; HR can pick the workspace's chosen employer contribution.

6. 6

   Save

   Audit log records HCM_BENEFITS_PLAN_CREATED.

Open enrollment

1. 1

   Click "Open enrollment window"

   Pick open + close dates; coverage start date.

2. 2

   Communication

   The platform notifies every active employee via their Account-Notifications preferences + posts to the Action Inbox. Audit log records HCM_BENEFITS_ENROLLMENT_WINDOW_OPENED.

3. 3

   Mid-window

   Track completion in the admin dashboard. Workspace can send nudge campaigns to non-responders.

4. 4

   Close enrollment

   Audit log records HCM_BENEFITS_ENROLLMENT_WINDOW_CLOSED. Mid-year change after this point requires a § 1.125-4 qualifying life event.

Transmit 834 to carriers

1. 1

   After enrollment closes, click "Generate 834"

   Per-carrier files generate from collected elections.

2. 2

   Review

   Per-employee per-plan summary with eligibility + dependents + contribution amounts. Audit log records HCM_BENEFITS_EDI_834_GENERATED.

3. 3

   Transmit (step-up)

   Step-up modal opens; transmission requires phishing-resistant proof. On verify, the file is sent to the carrier via the workspace's configured channel (SFTP / EDI gateway). Audit log records HCM_BENEFITS_EDI_834_TRANSMITTED at critical severity.

4. 4

   Carrier ack

   Carriers typically ack within 24-72 hours; the ack is recorded against the transmission.

COBRA continuation

Mid-year change processing (§ 1.125-4)

1. 1

   Employee files life event

   From Benefits enrollment. Audit log records HCM_BENEFITS_LIFE_EVENT_FILED.

2. 2

   HR reviews

   Documentation chain — marriage certificate, birth certificate, proof-of-loss-of-coverage — required per event type. The review surface shows the documents with SHA-256 lock + chain-of-custody.

3. 3

   Decision

   Approve / reject. Audit log records HCM_BENEFITS_LIFE_EVENT_APPROVED / ..._REJECTED.

4. 4

   Employee updates elections

   Within the workspace's life-event window (typically 30 days from event date).

5. 5

   834 update to carrier

   The mid-year change file is generated + transmitted per the carrier's accepted cadence.

Every field, explained

Audit codes

For SIEM ingestion + compliance review, this surface emits:

See Reference → Audit codes for the canonical description of each.

Common gotchas

• "Carrier rejected the 834." The ack file carries the rejection detail. Most common: a member-ID mismatch or a coverage-tier mismatch. Fix + retransmit.
• "Employee's mid-year change was rejected." § 1.125-4 requires documentation within the event window. The rejection rationale is recorded; employee can re-submit with corrected documentation if available.
• "COBRA premium isn't generating." Verify the qualifying event was recorded — HCM_BENEFITS_COBRA_NOTICE_SENT should fire on the termination event.
• "HSA contribution rejected — § 223 ineligible." Employee is enrolled in non-HDHP coverage or has another ineligibility blocker. The benefits-enrollment surface names which.

Troubleshooting