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Type:
Support Activity
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Status: Resolved
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Priority:
High
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Resolution: Done
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Affects Version/s: None
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Fix Version/s: None
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Component/s: ACA
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Labels:None
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Support Task Type:ACA Data Audit
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Environment:Production
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Reported by:Support
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Module:BenAdmin
Hi all - apologies if this is duplicate but I could not find it on my list.
From UHC -
We are attempting to create a Job Aide for ACA setup so we can apply right from the start rather than the trial and error we are doing now with all the back & forths. I created this grid with the fields and values, along with instructions on when to choose each option. I have a couple asks, can your experts look at it to:
Verify the info I completed in here is accurate?
Help fill-in Column D on if we can have all plans listed completed or only the plans for the reporting period (i.e. ’14 & ’16 plans when running reports for ’15)?
Answer our open questions in the last column?
Hi all - I think we need to revisit the question asked about the minimum value plan. The minimum value plan says that the plan must cover 60% of the services - not 60% of the premium. I don't know how the system would ever know that and feel that the client should always tell us which plans do and don't provide minimum value.
https://www.irs.gov/affordable-care-act/employers/minimum-value-and-affordability
Minimum Value
An employer-sponsored plan provides minimum value if it covers at least 60 percent of the total allowed cost of benefits that are expected to be incurred under the plan. See Notice 2014-69 for additional guidance regarding whether an employer-sponsored plan provides minimum value coverage if the plan fails to substantially cover in-patient hospitalization services or physician services. Under proposed regulations upon which taxpayers may rely, employers generally must use a minimum value calculator developed by HHS to determine if a plan with standard features provides minimum value. Plans with nonstandard features are required to obtain an actuarial certification for the nonstandard features. The proposed regulations also describe certain safe harbor plan designs that will satisfy minimum value.
Hi Jennifer Leugers,
WORKTERRA System is completely depend on the Is Minimum Value plan customization and not taking any decision itself on any available data.
Yes, previously we are taking the decision but in march 2016 we have changed the implementation and currently we are referring only Is Minimum Value customization.
UHC is pretty upset about this. We gave them the completed spreadsheet that is attached above in April and for when to check the is plan minimum value it says to only check it with ER contributions aren't built as well as the below comment -
if this box has been checked then system will assum that this Plan contribution is didided as ER 60: EE 40. If this is unchecked then system will calculate the Percentage from the Actaual rate allocation.
If we made the change in March, why did we provide them wrong information in April? I've really got to be able to explain this to UHC.
Hi Jennifer Leugers,
We have changed code in march 24 2016 for specific clients which are getting processed after 24 march only and not deployed for all client.we have released this after QA testing in late April.
Can you please suggest us how to avoid such issues , because we are currently developing new enhancement for WORKTERRA ACA.
See the list of Task planned ACA 2017 Enhancements.xlsx
Jennifer Leugers Please check and confirm.