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  1. WORKTERRA
  2. WT-12630

Employbridge > Health Tier Mapping Issue > Cigna EPO > Yuritzi Pacheco

    Details

    • Type: Support Activity
    • Status: Closed
    • Priority: High
    • Resolution: Done
    • Affects Version/s: None
    • Fix Version/s: None
    • Component/s: BenAdmin
    • Labels:
      None
    • Support Task Type:
      Data Correction
    • Environment:
      Production
    • Reported by:
      EDI
    • Company:
      Employbridge
    • Module:
      BenAdmin - Enrollment
    • Severity:
      Simple
    • Provider & Benefits:
      CIGNA-Medical

      Description

      Hello,

      I ran a health tier mapping audit and i see a blank coming up for Yuritzi Pacheco's 1/1/2018 record in Cigna EPO medical plan. SA utility re-calc did not remedy. Please resolve.

      Thanks,
      Chris

        Attachments

          Activity

          Hide
          rakesh.shahane Rakesh Shahane (Inactive) added a comment -

          Adding time log

          Show
          rakesh.shahane Rakesh Shahane (Inactive) added a comment - Adding time log
          Hide
          Chris.ellenberger Chris Ellenberger added a comment -

          I recalc'd and policy number is picking up now. Thank you.

          Show
          Chris.ellenberger Chris Ellenberger added a comment - I recalc'd and policy number is picking up now. Thank you.
          Hide
          amitthorve Amit Thorve (Inactive) added a comment -

          Chris Ellenberger You have to recalculate the policy number as Ganesh Sadawarte do not have access to SA Utility.

          Show
          amitthorve Amit Thorve (Inactive) added a comment - Chris Ellenberger You have to recalculate the policy number as Ganesh Sadawarte do not have access to SA Utility.
          Hide
          Ganesh.sadawarte Ganesh Sadawarte (Inactive) added a comment - - edited

          Hi Amit Thorve and Chris Ellenberger

          We have updated EE tier for 'Employee + Child + Domestic Partner Child' and also updated tier for this employee below enrollments as these enrollment got null health tier.

          1) Cigna EPO
          2) Dental - Metlife PPO High Option
          3) EyeMed Vision
          4) Accident Insurance A

          Please recalculate policy once and let us know if you face any issue.

          CC-Vinayak Kulkarni,Jyoti Mayne

          Thanks,
          Ganesh

          Show
          Ganesh.sadawarte Ganesh Sadawarte (Inactive) added a comment - - edited Hi Amit Thorve and Chris Ellenberger We have updated EE tier for 'Employee + Child + Domestic Partner Child' and also updated tier for this employee below enrollments as these enrollment got null health tier. 1) Cigna EPO 2) Dental - Metlife PPO High Option 3) EyeMed Vision 4) Accident Insurance A Please recalculate policy once and let us know if you face any issue. CC- Vinayak Kulkarni , Jyoti Mayne Thanks, Ganesh
          Hide
          amitthorve Amit Thorve (Inactive) added a comment -

          Ganesh Sadawarte Please do this correction ASAP. File is pending.

          Show
          amitthorve Amit Thorve (Inactive) added a comment - Ganesh Sadawarte Please do this correction ASAP. File is pending.
          Hide
          Chris.ellenberger Chris Ellenberger added a comment -

          Hello,

          I need this completed ASAP. Wasn't aware i need to approve a correction. I need to send the Cigna OE file to the carrier today.

          Thanks,
          Chris

          cc Amit Thorve

          Show
          Chris.ellenberger Chris Ellenberger added a comment - Hello, I need this completed ASAP. Wasn't aware i need to approve a correction. I need to send the Cigna OE file to the carrier today. Thanks, Chris cc Amit Thorve
          Hide
          rohit.shete Rohit Shete (Inactive) added a comment -

          Hi Chris Ellenberger,

          Please find below 3C's:

          Concern: Health tier mapping coming up blank for EE 'Yuritzi Pacheco's' for 1/1/2018 record in Cigna EPO medical plan.
          Cause:

          • For health tier 'Employee + Child + Domestic Partner Child' on customization screen, employee column is not selected. PFA screen shot.
          • Hence when EE enrolled in 'Cigna EPO' medical plan with 'Employee + Child + Domestic Partner Child', he got no heath tier and rate.

          Correction: As this health tier is not editable from UI, we need to do following.
          1. We will marked EE tier for 'Employee + Child + Domestic Partner Child' from back end
          2. We will do correction for impacted EE and corrected their rates.

          We have scanned all EE for all health plans and found below 1 EE got no health tier.

          First Name Last Name Plan Name Election Effective Date
          Yuritzi Pacheco Cigna EPO 01/01/2018
          Yuritzi Pacheco Dental - Metlife PPO High Option 01/01/2018
          Yuritzi Pacheco EyeMed Vision 01/01/2018
          Yuritzi Pacheco Accident Insurance A 01/01/2018

          Please provide your approval for same.

          Thanks and Regards,
          Rohit Shete.

          CC: Amruta Lohiya, Jyoti Mayne, Vinayak Kulkarni

          Show
          rohit.shete Rohit Shete (Inactive) added a comment - Hi Chris Ellenberger , Please find below 3C's: Concern: Health tier mapping coming up blank for EE 'Yuritzi Pacheco's' for 1/1/2018 record in Cigna EPO medical plan. Cause: For health tier 'Employee + Child + Domestic Partner Child' on customization screen, employee column is not selected. PFA screen shot. Hence when EE enrolled in 'Cigna EPO' medical plan with 'Employee + Child + Domestic Partner Child', he got no heath tier and rate. Correction: As this health tier is not editable from UI, we need to do following. 1. We will marked EE tier for 'Employee + Child + Domestic Partner Child' from back end 2. We will do correction for impacted EE and corrected their rates. We have scanned all EE for all health plans and found below 1 EE got no health tier. First Name Last Name Plan Name Election Effective Date Yuritzi Pacheco Cigna EPO 01/01/2018 Yuritzi Pacheco Dental - Metlife PPO High Option 01/01/2018 Yuritzi Pacheco EyeMed Vision 01/01/2018 Yuritzi Pacheco Accident Insurance A 01/01/2018 Please provide your approval for same. Thanks and Regards, Rohit Shete. CC: Amruta Lohiya , Jyoti Mayne , Vinayak Kulkarni
          Hide
          rakesh.shahane Rakesh Shahane (Inactive) added a comment -

          Hi Jyoti Mayne,
          We have checked the enrollment details for employee Yuritzi Pacheco, As per analysis We observed that HealthTierID is null for that enrollment.Please correct Enrollment data for same.

          Please let us know if you required more details.

          CC-Ganesh Sadawarte, Vinayak Kulkarni

          Show
          rakesh.shahane Rakesh Shahane (Inactive) added a comment - Hi Jyoti Mayne , We have checked the enrollment details for employee Yuritzi Pacheco , As per analysis We observed that HealthTierID is null for that enrollment.Please correct Enrollment data for same. Please let us know if you required more details. CC- Ganesh Sadawarte , Vinayak Kulkarni
          Hide
          gaurav.sodani Gaurav Sodani (Inactive) added a comment -

          Hi Vinayak,

          Please check this issue once

          Regards
          Gaurav

          Show
          gaurav.sodani Gaurav Sodani (Inactive) added a comment - Hi Vinayak, Please check this issue once Regards Gaurav

            People

            Assignee:
            Chris.ellenberger Chris Ellenberger
            Reporter:
            Chris.ellenberger Chris Ellenberger
            EDI Analyst 1:
            Chris Ellenberger
            Developer:
            Rohit Shete (Inactive)
            Votes:
            0 Vote for this issue
            Watchers:
            6 Start watching this issue

              Dates

              Created:
              Updated:
              Resolved:

                Time Tracking

                Estimated:
                Original Estimate - Not Specified
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                Remaining:
                Remaining Estimate - 0h
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                Logged:
                Time Spent - 9h 20m
                9h 20m