WORKTERRAProject Type: software

WORKTERRA

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  1. WORKTERRA
  2. WT-11120

Intrepid UMR Groupd File

    Details

    • Type: Support Activity
    • Status: Closed
    • Priority: Medium
    • Resolution: Done
    • Affects Version/s: None
    • Fix Version/s: None
    • Component/s: None
    • Labels:
      None
    • Support Task Type:
      Data Correction
    • Environment:
      Production
    • Reported by:
      Support
    • Module:
      BenAdmin - Export
    • Severity:
      Simple

      Description

      Employee Maria Martin - The UMR Medical File
      Per carrier Carol Bass, our file sent EE in code AO4 but for the children / child our file sent code AO3. This kicked out because they are asking why on different codes/plans. I show this EE is enrolled in FSA which is why EE is in the AO4code I think. Why do we send EE and child with different codes? This resulted in Issue for child Francisco Octavio. Any others impacted?

        Attachments

          Issue Links

          relates to

          Enhancement - An improvement or enhancement to an existing feature or task. WT-11726 need to develop new macro in rule engine as "Employee enrolled In"

          • Medium - Has the potential to affect progress.
          • Closed

            Activity

            Ascending order - Click to sort in descending order
            Damion.Velasquez Damion M Velasquez created issue -
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            Damion.Velasquez Damion M Velasquez added a comment -

            Hi Vinayak

            Can the team look into this? The REF1L that is mapped to Health Tier Policy no has a Conditional Rule. It is working for the subscriber but not dependents. The rule is pulling Benefittype HSCA being the FLEX. My assumption is that the Dependents are never enrolled in the Flex so never have a Benefittype of HCSA so Dependents are getting the Else Value. Is that correct?

            Rule set in REF 1L:
            If Enrollment Member Enrolled In Benefittype equal to HCSA
            Then REF02 Reference Identification(HEALTH COVERAGE POLICY) equal to 767000412194A04
            Else REF02 Reference Identification(HEALTH COVERAGE POLICY) equal to 767000412194A03

            Company Leel templates:
            UMR_834_5010_Gold_HSA
            UMR_834_5010_GOLD_HSA_ACTIVE_COBRA

            Show
            Damion.Velasquez Damion M Velasquez added a comment - Hi Vinayak Can the team look into this? The REF1L that is mapped to Health Tier Policy no has a Conditional Rule. It is working for the subscriber but not dependents. The rule is pulling Benefittype HSCA being the FLEX. My assumption is that the Dependents are never enrolled in the Flex so never have a Benefittype of HCSA so Dependents are getting the Else Value. Is that correct? Rule set in REF 1L: If Enrollment Member Enrolled In Benefittype equal to HCSA Then REF02 Reference Identification(HEALTH COVERAGE POLICY) equal to 767000412194A04 Else REF02 Reference Identification(HEALTH COVERAGE POLICY) equal to 767000412194A03 Company Leel templates: UMR_834_5010_Gold_HSA UMR_834_5010_GOLD_HSA_ACTIVE_COBRA
            Damion.Velasquez Damion M Velasquez made changes -
            Field Original Value New Value
            Assignee Vinayak Kulkarni [ vinayak.kulkarni ] Damion Velasquez [ damion.velasquez ]
            Status Open [ 1 ] In Progress [ 3 ]
            Damion.Velasquez Damion M Velasquez made changes -
            Link This issue relates to EDI-2426 [ EDI-2426 ]
            Damion.Velasquez Damion M Velasquez made changes -
            Assignee Damion Velasquez [ damion.velasquez ] Vinayak Kulkarni [ vinayak.kulkarni ]
            rakeshr Rakesh Roy (Inactive) made changes -
            Module Parent values: BenAdmin(10100) Parent values: BenAdmin(10100)Level 1 values: Export(10110)
            Hide
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            Vinayak.Kulkarni Vinayak Kulkarni (Inactive) added a comment -

            Hi Damion,

            Your assumption is very true, as dependents are never enrolled into Flex, "Member Enrolled in" from conditional rule is giving else value.

            As of now, We can not achieve this using any kind of customization change. We need to develop new macro in rule engine as "Employee enrolled In", and we can use this on Spouse and child sub-template which will solve our purpose.

            Let us know priority of this so that we can schedule development of "Employee Enrolled In" in rule engine. Thanks.

            Show
            Vinayak.Kulkarni Vinayak Kulkarni (Inactive) added a comment - Hi Damion, Your assumption is very true, as dependents are never enrolled into Flex, "Member Enrolled in" from conditional rule is giving else value. As of now, We can not achieve this using any kind of customization change. We need to develop new macro in rule engine as "Employee enrolled In", and we can use this on Spouse and child sub-template which will solve our purpose. Let us know priority of this so that we can schedule development of "Employee Enrolled In" in rule engine. Thanks.
            Vinayak.Kulkarni Vinayak Kulkarni (Inactive) made changes -
            Assignee Vinayak Kulkarni [ vinayak.kulkarni ] Damion Velasquez [ damion.velasquez ]
            Resolution Done [ 10000 ]
            Status In Progress [ 3 ] Resolved [ 5 ]
            Permalink
            Vinayak.Kulkarni Vinayak Kulkarni (Inactive) logged work - 15/Sep/17 02:49 PM
            • Time Spent:
              2.5h
               
              <No comment>
            Tkot Tracy Kot (Inactive) made changes -
            Resolution Done [ 10000 ]
            Status Resolved [ 5 ] Reopened [ 4 ]
            Tkot Tracy Kot (Inactive) made changes -
            Comment [ ~Damion.Velasquez] HI Damion, do the notes above mean this is not resolved for Client and that the dependents will continue to be wrong? This issue caused the dependent to NOT show to be eligible for their medical and prescription benefits. This is a BIG issue. This means the child was not able to get their medications for their benefits which means the EE immediately goes directly to client. This is a direct relation to our file. Can you please advise me on this issue as this ticket appears to have been closed as resolved but the notes above appear to indicate this issue is not resolved. Or did I mis-read the above notes? Can you please let me know on this ASAP this week. Again this is urgent since the children impacted can't used their benefits.
            [~Vinayak.Kulkarni] [~Damion.Velasquez ]
            Damion.Velasquez Damion M Velasquez made changes -
            Status Reopened [ 4 ] In Progress [ 3 ]
            Hide
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            Damion.Velasquez Damion M Velasquez added a comment -

            Yes let's move forward. We are sending the wrong code for all dependents when Employee enrolled in HCSA. Is there a quick solution by way if indicator or rule I could set until then. This is causing discrepancy and billing concerns

            Thank you

            CC Tracy Kot

            Show
            Damion.Velasquez Damion M Velasquez added a comment - Yes let's move forward. We are sending the wrong code for all dependents when Employee enrolled in HCSA. Is there a quick solution by way if indicator or rule I could set until then. This is causing discrepancy and billing concerns Thank you CC Tracy Kot
            Damion.Velasquez Damion M Velasquez made changes -
            Assignee Damion Velasquez [ damion.velasquez ] Vinayak Kulkarni [ vinayak.kulkarni ]
            Hide
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            Vinayak.Kulkarni Vinayak Kulkarni (Inactive) added a comment -

            Hi Damion,

            Request you to create new "Enhancement" JIRA and link this jira to it. Thanks.

            Amit Thorve

            Show
            Vinayak.Kulkarni Vinayak Kulkarni (Inactive) added a comment - Hi Damion, Request you to create new "Enhancement" JIRA and link this jira to it. Thanks. Amit Thorve
            Vinayak.Kulkarni Vinayak Kulkarni (Inactive) made changes -
            Assignee Vinayak Kulkarni [ vinayak.kulkarni ] Damion Velasquez [ damion.velasquez ]
            Resolution Done [ 10000 ]
            Status In Progress [ 3 ] Resolved [ 5 ]
            Vinayak.Kulkarni Vinayak Kulkarni (Inactive) made changes -
            Remaining Estimate 8h [ 28800 ]
            Original Estimate 8h [ 28800 ]
            Vinayak.Kulkarni Vinayak Kulkarni (Inactive) made changes -
            Remaining Estimate 8h [ 28800 ] 5.5h [ 19800 ]
            Time Spent 2.5h [ 9000 ]
            Worklog Id 80839 [ 80839 ]
            Damion.Velasquez Damion M Velasquez made changes -
            Link This issue relates to WT-11726 [ WT-11726 ]
            satyap Satya made changes -
            Environment_New Production [ 18442 ]
            Hide
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            Damion.Velasquez Damion M Velasquez added a comment -

            Can you close this? I dont have the option Thanks

            Show
            Damion.Velasquez Damion M Velasquez added a comment - Can you close this? I dont have the option Thanks
            Damion.Velasquez Damion M Velasquez made changes -
            Assignee Damion Velasquez [ damion.velasquez ] Vinayak Kulkarni [ vinayak.kulkarni ]
            Vinayak.Kulkarni Vinayak Kulkarni (Inactive) made changes -
            Status Resolved [ 5 ] Closed [ 6 ]
            Transition Time In Source Status Execution Times
            Damion M Velasquez made transition -
            Open In Progress
            		4m 46s 1
            Tracy Kot (Inactive) made transition -
            Resolved Reopen
            		3d 15h 11m 1
            Damion M Velasquez made transition -
            Reopen In Progress
            		20h 27m 1
            Vinayak Kulkarni (Inactive) made transition -
            In Progress Resolved
            		20h 14m 2
            Vinayak Kulkarni (Inactive) made transition -
            Resolved Closed
            		189d 17h 39m 1

              People

              Assignee:
              Vinayak.Kulkarni Vinayak Kulkarni (Inactive)
              Reporter:
              Damion.Velasquez Damion M Velasquez
              Account Executive:
              Tracy Kot (Inactive)
              EDI Analyst 1:
              Damion M Velasquez
              Votes:
              0 Vote for this issue
              Watchers:
              3 Start watching this issue

                Dates

                Created:
                Updated:
                Resolved:

                  Time Tracking

                  Estimated:
                  Original Estimate - 8h
                  8h
                  Remaining:
                  Time Spent - 2.5h Remaining Estimate - 5.5h
                  5.5h
                  Logged:
                  Time Spent - 2.5h Remaining Estimate - 5.5h
                  2.5h