Benefit Management in Public Sector

Note ​Public Sector Solutions is now ​A​gentforce Public Sector. You may see references to ​​Public Sector Solutions in Salesforce applications and documentation.

Offer eligible constituents monetary benefits such as social insurance, tax benefits, subsidies, food and housing assistance, or direct cash assistance. Offer assistance through a direct or indirect transfer of resources or credits for a specific period. For example, assist eligible low-income households with their heating and cooling energy costs by offering the Low Income Home Energy Assistance Program (LIHEAP).

Specify who is eligible to apply for the benefits based on their age, income, expenses, household size, and other criteria. Review and screen applications and approve the ones that are eligible. Assign benefits to eligible applicants and specify details such as the amount and frequency of the benefit. Configure benefits to be disbursed automatically for upcoming payment schedules or disburse them manually.

Enable constituents to search for benefits that they’re eligible for and apply for them. Also enable them to track the status of their applications and the benefits assigned to them, and view a schedule of payments that they can expect to receive. Also share the reasons behind these decisions with your constituents.

Note

Customer is solely responsible for any use of sample, example, or template benefit eligibility criteria, formulae, or similar schema provided with Benefit Management. Customer must ensure that any benefit eligibility decision-making by Customer using such sample, example, or template benefit eligibility determination tools are used: (i) only by authorized personnel of Customer; and (ii) in compliance with applicable laws and regulations to which Customer is subject.

• Benefit Management Prerequisites
  Before you set up benefit management in Public Sector (formerly Public Sector Solutions), complete the prerequisites.
• Set Up the Eligibility Assessment Flow for Your Benefit Assistance Site
  To specify eligibility criteria and set up the assessment, customize the Omniscript, create a decision matrix, build an expression set, and activate the Omniscript.
• Automate Eligibility Determinations
  Use Business Rules Engine to determine benefit eligibility and the benefit amounts for qualified applicants. First, create a decision matrix that defines the income threshold based on the income and household size. Then build an expression set that uses the matrix to find benefit eligibility and calculate eligible benefit amounts. Use Decision Explainer to share the reasoning behind application decisions, eligibility determinations, and benefit amount calculations with constituents.
• Deploy the Benefit Management Discovery Framework Template
  Deploy version 5 or later of the Discovery Framework sample template for benefit management in Public Sector (formerly Public Sector Solutions).
• Set Up Benefit Application Intake
  Use Discovery Framework assessment questions and Omniscripts to capture information from constituents who apply for a benefit. Store assessment questions responses in Salesforce objects using Omnistudio Integration Procedures and Omnistudio Data Mappers. Capture effective start and end dates when you store income and expense data. Use Business Rules Engine to automate benefit eligibility determination.
• Set Up the Change of Circumstances Application Flow
  Set up a guided flow on your Experience Cloud site that constituents can use to report changes of circumstance that affect benefit or service eligibility. Review the changes in an individual application record, and adjust the services or benefits assigned to constituents as necessary.
• Set Up the Benefit Recertification Flow
  Enable constituents to recertify for benefits on your Experience Cloud site. Show them benefits that are pending recertification and give them a guided flow to review the information that they previously provided, confirm or update details, upload supporting documents, and submit their recertification application.
• Set Up the Benefit Application Review Flow
  Configure a guided flow for caseworkers to use to check whether benefit, change of circumstances, and benefit recertification applications are complete and accurate, to determine eligibility, and to assign and adjust benefits and services.
• Alert Applicants When Their Benefit Application Status Changes
  Keep applicants informed of the progress of their benefit applications by using a flow to automatically send a desktop notification and an email to applicants when the status of their benefit application changes.
• Build a Benefit Assistance Experience Cloud Site in Public Sector
  Create an Experience Cloud site where constituents can apply and recertify for benefits, report a change of circumstances, and file complaints.
• Process Benefit Applications by Using a Guided Flow
  Check whether an application in review is complete and accurate. Correct details based on evidence and, if necessary, return the application for additional information. When the application is complete, if the applicants are eligible, assign them a benefit amount.
• Process Change of Circumstance Applications by Using a Guided Flow
  Check whether a change of circumstances application is complete and accurate. Correct details based on supporting documentation and, if necessary, return the application for additional information. When the application is complete and you have confirmed the details, accept or deny the application.
• Process Benefit Assignment Adjustment Applications by Using a Guided Flow
  Check the changes reported. View benefit assignment details and adjust the benefit amount to match the change in circumstances.
• Process Benefit Recertification Applications by Using a Guided Flow
  Check whether a recertification application is complete and accurate. Correct details based on supporting documentation and, if necessary, return the application for additional information. When the application is complete and you’ve confirmed the details, accept or deny the application. Renew or adjust the amount of benefits that constituents receive to match their benefit eligibility.
• Assign and Disburse Benefits to Eligible Applicants
  Assign benefits to eligible applicants and disburse the benefits by using flows in Public Sector (formerly Public Sector Solutions).
• Unified Constituent Profile for Benefit Management
  Bring together constituent benefit information, Einstein-generated summaries, priority alerts, and Data 360 insights on a single account page so your team can work cases from one place.