HCM – Benefits¶

Source: Admin Guide – Human Capital Management (May 14, 2026), pp. 1258–1545

Overview¶

Workday Benefits supports configuration of health, insurance, retirement savings, and wellness plans. Integrates with Payroll, Absence, and HR events.

Steps: Set Up Benefits¶

Manage Benefit Coverage Types — define categories (health care, health savings, retirement, spending accounts, insurance)
Access Maintain Health Care Classifications — configure provider org types (PPO, EPO, HMO, DHMO)
Define Benefit Coverage Targets — create Health Care Coverage Targets and Insurance Coverage Targets (employee-only, employee + spouse, family, etc.)
Create Benefit Providers — define insurance and plan providers
Create Enrollment Events — identify benefit gain/loss triggers and coverage types per event
Create Enrollment Event Rules — define coverage conditions (begin/end dates, increase limits, EOI, waiting periods)
Set Up Benefit Electronic Signatures
Create Benefit Eligibility Rules — group workers for similar benefit elections
Create Benefit Groups — workers must be in a benefit group to enroll
Define Benefit Plans — see Steps: Set Up Employee Benefit Plans
Configure Passive Events — benefit gains/losses from passage of time
Set up benefit credits and surcharges

Core Benefits Configuration¶

Benefit Groups and Eligibility¶

Task	Purpose
Create Benefit Eligibility Rules	Define criteria for grouping workers into benefit groups
Create Benefit Groups	Containers for eligible workers; workers must be in a group to enroll
Set Up Benefit Enrollment Instructions	Display instructional content during enrollment
Enable Worker Marital Status Update During Enrollment Events	Allow marital status changes during enrollment
Set Up Save for Later	Enable workers to save enrollment in progress
Custom Validations	Add org-specific validation rules to enrollment

Concept: Checking Benefit Group Eligibility — how Workday evaluates worker eligibility for benefit groups in real time.

Reference: Benefits and Pay Hub — combined hub for workers to view benefits and pay data.

Costs and Rates¶

Insurance Costs¶

Steps: Set Up Insurance Costs — configure cost structures for insurance plans.

Steps: Manage Individual Benefit Rates — manage employee-specific benefit rate assignments.

Task	Purpose
Create Health Care Rates	Define employee and employer contribution rates for health plans
Create Insurance Coverages	Define coverage amounts and tiers
Create Insurance Rates	Define premiums per coverage tier
Enter Individual Benefit Rates	Override standard rates for specific employees

Set Up Employee Benefit Plans¶

Setup Considerations: Payroll and Benefits¶

Key decisions: Payroll deduction timing, proration rules, deduction begin/end date behavior, arrear handling.

Plan Types¶

Plan Type	Task	Notes
Health Care	Create Health Care Plans	Configure provider, coverage targets, rates, network type
Decision Support	Set Up Decision Support for Medical Plans	Tools to help employees select plans
Insurance	Create Insurance Plans	Life, disability, supplemental insurance
Critical Illness	Setup Considerations: Critical Illness Insurance Plans	Special configuration for CI products
Retirement Savings	Create Retirement Savings Plans	401(k), 403(b), pension; includes contribution allocation rules
Health Savings Account	Create Health Savings Account Plans	HSA plans linked to HDHP
Spending Account	Create Spending Account Plans	FSA, dependent care FSA
Additional Benefit Plans	Create Additional Benefit Plans	Custom plan types (e.g., wellness reimbursement, commuter)

Reference: Health Savings and Spending Accounts Enrollment Options — enrollment mechanics for HSA/FSA.

Benefits Knowledge Base¶

Task	Purpose
Set Up Benefits Knowledge Base Articles	Create plan-specific help content
Generate Help Article for Benefit Plan	AI-assisted article generation per plan

Benefit Programs¶

Steps: Set Up Benefit Programs — configure benefit program cards and wellness wallet.

Task	Purpose
Set Up Security and Endpoints for External Benefit Program Partners	Third-party program integration
Configure Benefit Program Cards	Worker-facing benefit program tiles
Configure the Benefits and Wellbeing Wallet	Employer contribution/reimbursement wallet
Set Up the Worker Wellbeing Profile Card	Display wellness profile data

Enrollment Events and Rules¶

Steps: Set Up Enrollment Events and Rules¶

Create Enrollment Events (define triggers: new hire, life event, open enrollment, termination)
Create Enrollment Event Rules (define conditions per event type: coverage dates, waiting periods, increase limits, EOI)
(Optional) Create Conditional Messages for Enrollment Events

Enrollment Workflows¶

Task	Purpose
Enrolling New Hires in Benefits	Auto-initiate benefit enrollment on hire event
Discontinue Benefits on Termination	Configure benefit end on termination
Steps: Set Up Automatic Benefit Eligibility Checks	Automated eligibility re-evaluation

Concept: Enrollment Period for Benefit Events — how enrollment windows open and close per event type.

Concept: Coordination of Benefits Enrollment Events — handling concurrent enrollment events.

Concept: Multiple Benefit Events on the Same Day — priority and processing order.

Concept: Plan Changes and Waiting Periods — interaction between plan changes and waiting period start dates.

Reference: Benefit Deduction Begin Date Rules — how Workday determines when deductions start.

Reference: Benefit Deduction End Date Rules — how Workday determines when deductions end.

Default Coverage and Auto-Enrollment¶

Task	Purpose
Steps: Set Up Auto-Contribution Increase for Retirement Plans	Annual auto-escalation for retirement savings
Enroll Workers into Retirement Savings Plans with Default Contribution Increases	Auto-enroll with escalation
Enroll Workers into Retirement Savings Plans Managed by Third-Party Providers	Third-party recordkeeper integration
Set Up Default Benefits Coverage	Define coverage applied when workers don't self-enroll
Set Up Auto-Enrollment for Benefit Plans	Automatically enroll eligible workers

Cross Plan Dependencies¶

Task	Purpose
Create Cross Plan Enrollment Prerequisites	Require enrollment in Plan A to enroll in Plan B
Create Cross Plan Insurance Coverage Maximums	Cap total coverage across plans
Create Cross Plan Insurance Percentage Maximums	Cap coverage as % of another plan
Create Cross Plan Retirement Savings Plan Contribution Maximums	Cap contributions across plans

Benefit Credits and Surcharges¶

Task	Purpose
Steps: Set Up Benefit Credits	Configure employer credits applied to benefit costs
Steps: Set Up Benefit Surcharges	Configure additional charges (e.g., tobacco surcharge, spousal coverage surcharge)
Create Benefit Annual Credit Types	Define credit categories
Create Benefit Credits	Specific credit amounts and rules
Create Benefit Credit Bundles	Group credits for assignment as a set
Assign Benefit Credits to a Benefit Group	Apply credit bundles to eligible groups
Create Benefit Surcharges	Define surcharge rules and amounts
Change Wellness Data	Update wellness-linked credit/surcharge data

Concept: Benefit Credits and Surcharges — interaction between credits, surcharges, and employee net cost calculations.

Multiple Jobs and Benefits¶

Task	Purpose
Steps: Set Up Multiple Jobs for Benefit Eligibility	Configure benefit eligibility across multiple jobs
Create Selection Rules for Benefit Jobs	Define which job determines benefit eligibility
Assign Benefit Job Selection Rules to Benefit Groups	Link rules to groups
Change Jobs Used for Benefit Eligibility	Update job selection for existing workers

Open Enrollment¶

Setup Considerations: Open Enrollment¶

Key decisions: Enrollment window dates, plan year definition, auto-save, communications, corrections workflow.

Steps: Set Up Open Enrollment¶

Create Benefit Plan Year Definitions
Configure enrollment event rules for open enrollment
Set up benefits messaging and reminders

Steps: Manage Open Enrollment¶

Task	Purpose
Start Open Enrollment	Initiate the enrollment event for eligible workers
Add Employees to Open Enrollment	Include additional workers mid-event
Remove Employees from Open Enrollment	Exclude specific workers
Send Benefits Messages	Communicate plan changes, deadlines
Send Open Enrollment Reminders	Automated reminder notifications
Close Open Enrollment	End the enrollment period
Finalize Open Enrollment Elections	Lock in elections; generate payroll deductions
Reopen Open Enrollment	Re-open for corrections
Correct an Employee's Open Enrollment Elections	Admin correction of locked elections

Concept: Enrollment Status Indicators — visual indicators showing worker enrollment progress.

Concept: Benefits Enrollment Events on Mobile — mobile enrollment experience.

Benefit Changes¶

Task	Purpose
Change Benefit Elections	Process life event or qualifying event changes
Change Retirement Savings Elections	Update contribution elections
Finalize Open Benefit Event Elections	Lock in life event elections
Correct Benefits	Retroactive correction of benefit elections
Extend Benefits Coverage for an Individual Employee	Extend coverage beyond standard end date

Passive Events¶

What They Are: Benefits changes triggered by passage of time (not by worker actions). Example: age-out of dependent, end of waiting period.

Steps: Set Up Passive Events: 1. Set Up Passive Event Business Processes 2. Create Passive Event Rules (conditions and resulting actions) 3. Schedule Passive Events (run frequency)

Concept: Passive Event Rules — how rules are evaluated and triggered.

Concept: Preview Alerts for Passive Events — review upcoming passive event triggers before processing.

Evidence of Insurability (EOI)¶

What It Is: Required medical underwriting for coverage above guaranteed issue amounts.

Task	Purpose
Steps: Set Up Evidence of Insurability	Configure EOI requirements per plan/coverage level
Steps: Manage Evidence of Insurability	Process and track EOI applications
Correct Employee EOI Approval and Denial Dates	Admin corrections

Concept: Evidence of Insurability Processes — workflow for EOI submission, review, and approval.

COBRA¶

Task	Purpose
Steps: Set Up COBRA Automation	Configure automatic COBRA eligibility on qualifying events
Grant COBRA Eligibility	Manually grant COBRA to a former worker
Correct COBRA Eligibility Records	Fix COBRA eligibility data
Grant COBRA to an Ex-Spouse	QDRO-related COBRA extension

Patient Protection and Affordable Care Act (ACA)¶

Setup Considerations: ACA Reporting¶

Key decisions: ALE status, measurement method (monthly or look-back), reporting configuration, 1094-C/1095-C setup.

Task	Purpose
Steps: Set Up ACA Measurements and Eligibility	Configure measurement periods and FTE thresholds
Steps: Set Up ACA Software Partner Transmission	Electronic filing integration
Steps: Set Up ACA Forms 1094-C and 1095-C	Configure form data and employer information
Steps: Import ACA 1095-C Recipient Data	EIB import for recipient data
Create ACA Measurement Periods	Define standard and initial measurement periods
Create an ACA Company Configuration	Per-company ACA settings
View and Correct ACA Data Transmission Status	Monitor IRS transmission

Reference: Affordable Care Act 1095-C Form Codes — code reference for line 14 and line 16 reporting.

Medicare¶

Steps: Set Up Medicare Tracking — configure Medicare secondary payer (MSP) tracking.

Manage Medicare Information — maintain worker Medicare status for insurance coordination.

Dependents and Beneficiaries¶

Task	Purpose
Manage Personal Relationship Types	Define relationship types (spouse, domestic partner, child)
Manage Dependents and Beneficiaries	Add, edit, and remove dependents and beneficiaries
Add or Delete Court-Ordered Benefits (QDRO)	Process qualified domestic relations orders
Steps: Set Up Fair Market Value for Health Care Plans	Configure imputed income for domestic partner coverage
Assign a Verification Status to Dependents	Track dependent eligibility verification
Purge Dependents and Beneficiaries	GDPR-related data removal for terminated workers

Wellness¶

Concept: Workday Wellness — integration with wellness program partners; tracks wellness activities linked to benefit credits/surcharges.

Task	Purpose
Steps: Set Up Workday Wellness	Enable wellness module and configure basics
Steps: Set Up Workday Wellness and Connect Wellness Partners	Third-party partner integration
Steps: Configure Worker Data and Enrollments	Map worker data for wellness programs
Steps: Manage Wellness Data Errors	Troubleshoot wellness data sync issues
Steps: Configure Plan Setup Insurance	Wellness-linked insurance configuration
Steps: Configure Evidence of Insurability	Wellness-driven EOI integration
Steps: Configure Worker Communication Cards	Wellness-specific worker communication
Steps: Set Up Connected Absence for Wellness Partners	Absence tracking integration with wellness

Reference: Workday Wellness Key Terms — glossary of wellness-specific terminology.