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Type:
Bug
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Status: Closed
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Priority:
Medium
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Resolution: System Behaviour
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Affects Version/s: None
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Fix Version/s: None
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Component/s: BenAdmin
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Labels:None
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Environment:Production
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Bug Severity:Medium
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Module:BenAdmin - Enrollment
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Reported by:Client
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Company:Utah Valley University
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Stage Company Name:UVU
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Item State:Development - In Analysis
Hello,
For UVU, could you please review the way that the system is calculating the ER contribution?
UVU is currently set to have an ER contribution that is monthly prorated. They are a 7/1 plan year.
For EE only, the ER contribution is: $900 annually or $75 monthly
For Family, the ER contribution is: $1800 annually or $150 monthly
For these members, who have had a tier change mid year, the system seems to be giving both the EE and family contribution for the month that they had a change. I believe that that system should only be giving the increased family tier for that month.
For instance, Kameron Dearing. He had a tier change on 9/29. The system is giving the single ER contribution from 7/1 - 10/1 ($75*4 = $300) and the family ER contribution from 10-1 - 6/1 ($150*9 = $1,350), which gives the total ER contribution of $1,650. For the month of October, it should really only be taking the family contribution and not the single ER contribution, so he should really only have a total of $1,575 for the employer contribution.
We have a few other examples of where this is happening: Mona Blythe, Johnathan Hardy, Chet Carson.
Thanks,
Robyn
CC: Jennifer Johnson, Deborah Larue
Robyn Adkison - per DEV this is not a bug, but system behavior. Please let us know if you think differently. CC Jyoti Mayne Jennifer Reed
(I could not "resolve" it, the only option I had was to "Reject".)
Hi Abhay Patil,
For second period i.e. 9/28/17 to 6/30/18, completed months are 10 not 9. System count month based on completed month not by exact month difference between election effective date and election termination date.
| Sr.No | Start Month | End Month | Count |
| 1. | 9/28/17 | 9/30/17 | 1 |
| 2. | 10/1/17 | 10/31/17 | 1 |
| 3. | 11/1/17 | 11/30/17 | 1 |
| 4. | 12/1/17 | 12/31/17 | 1 |
| 5. | 1/1/18 | 1/31/18 | 1 |
| 6. | 2/1/18 | 2/28/18 | 1 |
| 7. | 3/1/18 | 3/31/18 | 1 |
| 8. | 4/1/18 | 4/30/18 | 1 |
| 9. | 5/1/18 | 5/31/18 | 1 |
| 10. | 6/1/18 | 6/30/18 | 1 |
| Total Months | 10 |
Cc: Rohan J Khandave
Jyoti Mayne - I have a question about Kameron Dearing case.
| Effective Date | Termination Date | Health Plan Tier | Actual duration | Completed Months | ER Coverage |
|---|---|---|---|---|---|
| 7/1/17 | 9/27/17 | EE | 2m 27d | 2 | 75*2 = 150 |
| 9/28/17 | NULL (effectively 6/30/2018 | EE+SP | 9m 3d | 10 | 150*10 = 1500 |
Here for the first period system is taking "completed months" as 2, which is understood. However in the second case there are 9 completed months, but system is taking it as 10. Can you please explain what is the logic, as it doesn't look like "complete months"?
Robyn Adkison : Any updates on this?
_____________________________________________
Jyoti Mayne Rohan J Khandave
Hi Robyn Adkison,
Please find below details.
Customization of '2017 Health Savings Account' plan:
-Plan effective date 7/1/17 and plan termination date is 6/30/18.
-Employer Prorate Contribution type is Monthly.
-HSA plan is contingent on 'High Deductible Choice Plus' and 'High Deductible Options PPO' health plan.
1. EE 'Kameron Dearing' is having following election in '2017 Health Savings Account' plan.
| Effective Date | Termination Date | Health Plan Coverage Tier |
| 7/1/17 | 9/27/17 | EE |
| 9/28/17 | NULL | EE+SP |
As per current system implementation, it is calculating months based on 'completed month'.
For 7/1 to 9/27 election, lapsed month are 2.
For 9/28 election, remaining month are 10.
So 75*2 =150 and 150*10 =1500
| Total ER coverage = 150 + 1500 = $1650 |
2. 'Mona Blythe' is having following elections in '2017 Health Savings Account' plan:
| Effective Date | Termination Date | Health Plan Tier | Completed Months | ER Coverage |
| 7/1/17 | 12/30/17 | EE | 5 | 75*5 = 375 |
| 12/31/17 | NULL | EE+SP | 7 | 150*7 = 1050 |
| Total ER Coverage = 375+1050 = $1425 |
3. 'Jonathan Hardy' ER Calculation Details:
HSA ER coverage is always get calculated from health plan election effective date as they are contingent on Health Plan.
He enrolled in 'High Deductible Choice Plus' plan with 1/1/16 to NULL with EE+SP+2CH tier.
He enrolled in HSA plan with 'HSA Contribution Plans' QE effective 10/16/17 to NULL.
He waived HSA plan for period 7/1/15 to 10/15/17.
Here system will allocate ER coverage by considering parent plan effective date of 7/1/17. So he got $1800 ER coverage for whole year.
4. 'Chet Carson' ER Calculation Details:
He enrolled in parent plan with EE tier with 12/31/2017 effective date.
His HSA election is with 12/31/2017 effective date.
From 12/31/2017 remaining months are 7. So 75*7 = $525 is the ER coverage.
Please let us know in case of any queries.
Cc: Rohan J Khandave
Hi Jyoti Mayne,
Checked this issue for EE 'Kameron Dearing'. The yearly ER coverage is showing as 1650.
The Calculations are as follows.
The Yearly Coverage is from '7/1/2017' to '6/30/2018' (i.e is from July 2017 to June 2018)
Tier wise coverage
EE = 900 (75*12)
EE + SP = 1800 (150*12)
Spouse was added on '10/27/2017' Effective from '9/29/2017'.
The system calculated cost for EE only tier from July to Oct (75*4) = 300
and then again considered the oct month for EE + SP coverage and calculated cost from oct to june (150 * 9) = 1350
Total = 1650
Instrad, the system should have considered EE only tier cost till month of Sept
July to sept (75*3) = 225
and EE + SP cost from Oct to June (9*150) = 1350
Total = 1575
(Please refer the screenshots below)
Request you to please look into this.
Thank you,
------------
CC: Prashant Samal, Satya, Sumeet.Kolge
Prasad Patil (Inactive)
added a comment - Hi Jyoti Mayne ,
Checked this issue for EE 'Kameron Dearing'. The yearly ER coverage is showing as 1650.
The Calculations are as follows.
The Yearly Coverage is from '7/1/2017' to '6/30/2018' (i.e is from July 2017 to June 2018)
Tier wise coverage
EE = 900 (75*12)
EE + SP = 1800 (150*12)
Spouse was added on '10/27/2017' Effective from '9/29/2017'.
The system calculated cost for EE only tier from July to Oct (75*4) = 300
and then again considered the oct month for EE + SP coverage and calculated cost from oct to june (150 * 9) = 1350
Total = 1650
Instrad, the system should have considered EE only tier cost till month of Sept
July to sept (75*3) = 225
and EE + SP cost from Oct to June (9*150) = 1350
Total = 1575
(Please refer the screenshots below)
Request you to please look into this.
Thank you,
------------
CC: Prashant Samal , Satya , Sumeet.Kolge Hi Rohan,
Please look into this.
_____________________________________
Rohan J Khandave Jyoti Mayne Umesh Kadam Satya
Thank you Abhay Patil!
We'll communicate to the client that the system is working per design. I didn't realize that it was based on months completed. For some reason I had thought it was a wash rule type of system, where the new tier would apply only if made prior to the 15th of the month.
Thank you again for all of the research. I will close the ticket.
Jyoti Mayne, Jennifer Reed