Benefits is Netchex's comprehensive benefits administration module. It brings every component of benefits management into one application that works directly alongside your payroll platform — improving accuracy, saving time, and strengthening compliance. It delivers real-time updates to deductions and eligibility, reduces manual work, tracks ACA information, provides an open enrollment platform, and gives employees a clearer view of their pay and benefits in one place.

A few things to know before you start

• Implementation requires active participation — benefits setup is more hands-on than payroll implementation; your team needs to stay engaged throughout.
• Benefits must be live before COBRA can be configured — if you use COBRA, set up Benefits fully first and plan your timeline accordingly.
• Open enrollment requires a 30-day lead time — Benefits must be active for a full 30 days before you can run open enrollment in the system.
• Deduction management shifts to you post-implementation — once implementation is complete, Netchex won't change benefit-related employee deductions; your team manages those going forward (with guidance).
• Carrier connections require file feeds — there's no automatic connection to your carrier unless file feeds are purchased; otherwise updates are handled manually. Contact your account manager about adding file feeds.

Navigating Benefits

To access the module, select Benefits from the menu on the left. The two primary areas are Plans and the Activity Manager:

• Plans displays every benefit plan built into your system. Selecting any plan opens a consistent menu — the same sections appear regardless of benefit type, so navigating medical, dental, vision, and other plans works the same way once you learn the layout.
• Activity Manager is your administrative dashboard for benefit activity — pending actions, eligibility changes, enrollment requests, and qualifying life events that need attention. You can act directly here: confirming or denying elections, processing life event changes, or finalizing open enrollment updates.

Notifications

To stay on top of Activity Manager updates, configure email and text notifications under Maintenance → Human Resources → Email/Text Event Configuration. The four most recommended for administrators are Employee Open Enrollment Notification, Employee Completed Open/Initial Enrollment, Employee Benefit Eligible, and Employee QLE Request Submitted.

The employee benefits overview

Employees have a benefits overview page in their self-service portal (left-hand menu under Benefits, alongside their Open Enrollment link). It summarizes all active enrollments at a glance: a total cost per paycheck and active-benefit count at the top, then each plan as its own card showing the plan name, carrier, coverage level, enrolled dependents, and per-paycheck cost. Life/supplemental plans also show benefit amounts by employee, spouse, and child with a link to manage beneficiaries. Each card links to carrier info and plan documents, and employees can see pending changes and plans they're eligible for now or in the future.

This session covers the foundational configuration of a benefit plan — plan setup, coverage levels, and plan documentation. We'll use a medical PPO as the example, but the process is consistent across medical, dental, vision, and other benefit types.

Accessing a plan

Under Benefits, select the Plans page to see every plan built into your system, then select a plan to open its detail menu.

Plan setup

The first area is Plan Setup, where you manage the plan's foundational details: plan type, group number and plan number, carrier details, and open enrollment dates. These are straightforward to review and update. Note that open enrollment dates are entered here at the plan level — make sure they're set before your enrollment window opens.

Coverage levels & rates

The Coverage Level section defines the cost of the plan by coverage tier. A standard medical plan typically has four tiers — employee only, employee plus spouse, employee plus child, and family. Within each tier you'll find:

• The employee cost and employer contribution (reflected per month).
• The deduction code used in payroll to represent the benefit — this drives how much is deducted each cycle, based on the employee's pay schedule and deduction cycle.
• Eligibility parameters for dependents, including minimum and maximum age requirements.

This section is critical to get right, since it directly affects what employees and the company are charged per pay period.

Plan documentation & other tools

The Plan Documentation section is especially important if employees enroll through their self-service portal. Upload documents here — plan summaries, coverage details, or other materials — and they'll appear on the Enrollment Introduction page when employees begin enrolling.

The plan menu also includes a few other useful areas:

• Mass Add, Update, or Decline — apply benefit changes to one or many employees within a plan.
• Plan Transition — move employees from one plan to another (e.g., when a plan is discontinued).
• Plan Renewal — roll plan details forward for a new benefit year. For detailed guidance on transition and renewal, see the Experience Hub.

Eligibility rules determine which employees qualify for a given plan — and when their coverage begins — based on data in the employee record. You define the criteria once at the plan level and the system applies them automatically, so plans stay aligned with your policies without manually assigning each employee.

Accessing eligibility criteria

Eligibility is configured at the plan level. Go to Benefits → Plans, select the plan, and choose Eligibility Criteria from the plan menu. You can define eligibility by division, employee status, employee type, salary grade, specific positions, and more — so you can, for example, offer a medical plan only to full-time employees in a certain division, or restrict a supplemental plan to a particular salary grade.

Waiting periods

Waiting periods are also configured within Eligibility Criteria. A waiting period defines how long an employee must wait after an event — typically their hire date — before becoming eligible. For example, if your policy requires a 30-day wait after hire, you set that here; the system then calculates the eligibility date automatically and prevents enrollment until the waiting period is satisfied. Because waiting periods apply at the plan level, you can set different ones per plan — for instance, immediate eligibility for dental but a 60-day wait for medical.

Dependent eligibility

In addition to plan-level eligibility, the Coverage Level section (from Session 2) contains dependent-specific parameters — minimum and maximum age requirements per coverage tier. This is where you'd configure, for example, a dependent child to age off coverage at 26.

This session covers configuring open enrollment — setting enrollment dates, preparing plan options, and understanding what employees see when they enroll.

Two requirements first

• Benefits must be fully implemented and active for at least 30 days before open enrollment can run in the system.
• All plans that should appear must be built — configured with correct coverage levels and eligibility criteria (Sessions 2 and 3). Confirm these are complete before proceeding.

Setting open enrollment dates

Open enrollment dates are set at the plan level. Go to Benefits → Plans, select a plan, and open Plan Setup to enter the enrollment start and end dates. Repeat for each plan that should be in the enrollment window, using matching or appropriate dates for a consistent employee experience.

Plan Transition & Plan Renewal

When preparing for a new benefit year, two tools in the plan menu become relevant: Plan Renewal rolls plan details forward into the new year so you can update rates without rebuilding, and Plan Transition moves employees from one plan to another (for example, when a plan is discontinued). See the Client Experience Hub for detailed guidance.

The employee enrollment experience

Employees access enrollment from their self-service portal via My Benefits → Open Enrollment, or through the To Do section by selecting Enroll in Benefits. The flow walks them through:

• Introduction page — displays all plans they're eligible for, plus any plan documentation you uploaded.
• Dependent and beneficiary verification — confirm, update, or add dependents/beneficiaries before proceeding.
• Plan elections — move through each benefit type (medical, dental, vision, etc.) to enroll, change coverage level, or decline.
• Decline reasons — if they decline a plan type, they pick a reason (covered elsewhere, cost, other) at the plan-category level.
• Summary and e-signature — a summary of elections with coverage levels and per-pay-period costs; they review, sign electronically, and save to finalize.

This session covers managing open enrollment from the admin side while the window is active — monitoring progress, reviewing elections, and taking action.

The Activity Manager during open enrollment

Once the window opens, the Activity Manager (Benefits → Activity Manager) is your primary tool. During an active cycle it displays pending open enrollment submissions, completed confirmations awaiting review, eligibility notifications for newly eligible employees, and other benefit activity requiring action. The view is organized by month, and you can toggle time periods or enter a custom date range.

The Enrollment Dashboard

Administrators also have a real-time Enrollment Dashboard (Benefits → Enrollment Dashboard). Three summary panels — Open Enrollment, Initial Enrollment, and Qualifying Life Events — give instant counts of where employees stand: Not Started, Submitted (pending admin confirmation), and Completed. The Open Enrollment panel tracks employees in an active window; Initial Enrollment shows those hired in the last 90 days; QLE shows events submitted in the last 90 days.

Below the panels you can search by name, email, position, or division, and filter by company (helpful across multiple company codes) and employee type. The list is organized into Not Started, Submitted, and Completed tabs. From the Not Started tab you can select employees and send a reminder email — note that only employees who haven't started can be reminded; those who've submitted or completed won't appear there.

Confirming elections

Use the Enrollment Dashboard to monitor and remind, and the Activity Manager to review and confirm. When an employee completes enrollment, their submission appears in the Activity Manager; select their name to review the request, then choose Confirm or Deny. Confirming is what actually applies the elections — until then, the enrollment stays pending.

If needed, admins can complete enrollment directly from the employee's profile: People → Employees, locate the employee, scroll to the Benefits card, and select the Open Enrollment tab. The admin flow mirrors the employee experience and also lets you adjust employee/employer deduction amounts (useful for grandfathered rates). Choose Save as Pending to route it to the Activity Manager for confirmation. After confirmation, the Summary of Current Benefits tab provides a PDF-style report of current enrollments, eligible/declined plans, per-payroll deductions, pending changes (in bold), and the confirmation date, confirmer, and signature.

Life events — also called qualifying life change events (QLEs) — are specific circumstances that let an employee change their benefit elections outside the standard open enrollment window. Federal and plan guidelines define which events qualify.

Common qualifying life events

• A reduction in hours that changes status from full-time to part-time.
• Marriage or divorce.
• Birth or adoption of a child.
• Death of a dependent.
• A dependent aging out of coverage (typically at age 26).

If your organization uses NetCOBRA, selecting a qualifying life event that affects a dependent's coverage will automatically initiate a COBRA notification to the employee and/or affected dependent.

Processing a life event

Life event changes are made from the employee's profile in the admin view. Go to People → Employees, locate the employee, scroll to the Benefits card, and select the Qualifying Life Change and Administrative Change Events tab. Choose the appropriate event type, enter an effective date (current or future, depending on when the change takes effect), then return to the top and click Continue.

The flow that follows mirrors open enrollment: an introduction page of eligible plans, dependent and beneficiary verification, medical/dental/vision plan pages (enroll, decline, or adjust), decline reasons, and a summary. To finalize, enter your e-signature and select Save and confirm the data now, which applies the changes based on the effective date.

Administrative changes vs. life events

For changes that don't fall under a qualifying life event — minor corrections or administrative updates — select Administrative Changes from the same tab. The process is identical (select the change type, set an effective date, work through the flow), but administrative changes are intended for corrections only. If a change is driven by a life event, always use the appropriate QLE type so documentation and any required COBRA notifications are triggered.

Before processing an event that adds or removes a dependent, make sure the dependent and beneficiary info in the profile is current — manage it from the employee profile under the Personal Info card → Beneficiaries tab, or add/update it during the life event flow on the Dependent and Beneficiary Verification page.

This final session covers the reporting tools in Benefits, an overview of ACA Central, and how carrier file feeds work.

Commonly used reports

Benefits includes several reports useful for auditing, carrier communication, and tracking enrollment. Access them from the Reports page on the left, or under Benefits. The four you'll use most:

• Anticipated Billing Report — shows what you expect to be billed based on current enrollments; a great starting point for auditing and catching discrepancies before a billing cycle or after a major enrollment event.
• Benefits Census Report — a comprehensive view of current enrollments with employee demographics; your go-to for brokers and carriers.
• Pending Benefits Report — all enrollment data currently in a pending state (open or initial enrollment); shows what's submitted but not yet confirmed.
• Pending Enrollment Report — focuses on pending changes within open/initial enrollment; useful for tracking edits awaiting confirmation.

Run the Anticipated Billing Report regularly as part of your audit routine, and keep the Benefits Census Report handy when working with your broker or carrier on renewals.

Summary of Current Benefits & Benefits History

The Summary of Current Benefits is a PDF-style report available to employees in the ESS portal and to admins from the employee profile (Benefits card → Summary of Current Benefits tab). It lists all current enrollments, eligible-but-unelected plans, declined plans, per-payroll deductions, pending changes (in bold), and the most recent enrollment date, confirmer, and signature. The Benefits History section on the Benefits card provides a full record of past changes — when initial enrollment completed, plans selected, effective dates, deduction details, and plan status — the go-to reference for tracing how benefits changed over time.

Carrier file feeds

By default, there's no automatic connection between Benefits and your carriers. Without file feeds, all updates and enrollment data must be communicated to carriers manually. If file feeds are part of your package, Netchex transmits enrollment and change data directly to your carrier, eliminating manual reporting and reducing discrepancies. Contact your account manager to confirm or add file feeds.

ACA Central

ACA Central (select it from the left menu) is the centralized home for your ACA data. The dashboard provides key reports including full-time equivalency, affordability, and the 1095-C import section, which shows a month-by-month breakdown and flags months with missing data. Before completing setup, review the Things to Know Before Starting ACA Central guide; if you can't answer its questions, consult your benefits broker. Key tabs include:

• ACA Setup — indicate whether you're an Applicable Large Employer (ALE) and define your initial and standard measurement periods.
• Reports page — enter your Safe Harbor minimum plan premium and set your full-time equivalency threshold (default 30 hours/week).
• Form 1094-C and 1095-C tab — opt out of Netchex processing 1095-C forms if desired, select your Safe Harbor method (W-2, federal poverty level, or rate of pay), and manage ALE groups.
• Exclude Employees from 1095-C — add anyone who shouldn't receive a 1095-C; Netchex won't generate a form for them.
• Edit 1094-C Report — update company name/address, review eligibility certifications, and preview the 1094-C before submission to the IRS.

The dashboard also offers coverage code cheat sheets, a 1095-C History Import for historical data before Benefits was active, and a Check History Import for hours worked during measurement periods before your Netchex payroll start. ACA Central only tracks data once Benefits is active, so earlier data must be imported manually. It's your responsibility to review ACA forms for accuracy — Netchex doesn't audit your ACA data — so review your 1095-C forms each January.