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  1. WORKTERRA
  2. WT-1862

ACA Customization Questions from UHC

    Details

    • Type: Support Activity
    • Status: Resolved
    • Priority: High
    • Resolution: Done
    • Affects Version/s: None
    • Fix Version/s: None
    • Component/s: ACA
    • Labels:
      None
    • Support Task Type:
      ACA Data Audit
    • Environment:
      Production
    • Reported by:
      Support
    • Module:
      BenAdmin

      Description

      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?

        Attachments

          Activity

          Hide
          nandkumar Nandkumar Prabhakar Karlekar (Inactive) added a comment -

          Workterra ACA Customization Settings.xlsx

          only the plans for the reporting period need to be filled with this customization.

          Show
          nandkumar Nandkumar Prabhakar Karlekar (Inactive) added a comment - Workterra ACA Customization Settings.xlsx only the plans for the reporting period need to be filled with this customization.
          Hide
          jennifer.leugers Jennifer Leugers added a comment -

          Hey Nandu - is there a response to rows 22 and 23? There wasn't anything in column F for that.

          Show
          jennifer.leugers Jennifer Leugers added a comment - Hey Nandu - is there a response to rows 22 and 23? There wasn't anything in column F for that.
          Hide
          nandkumar Nandkumar Prabhakar Karlekar (Inactive) added a comment -

          final Workterra ACA Customization Settings-1.xlsx

          Please find the response to rows 22 and 23 as per WORKTERRA implementation.

          Show
          nandkumar Nandkumar Prabhakar Karlekar (Inactive) added a comment - final Workterra ACA Customization Settings-1.xlsx Please find the response to rows 22 and 23 as per WORKTERRA implementation.
          Hide
          rakeshr Rakesh Roy (Inactive) added a comment -

          Jennifer Leugers Is there anything pending from our side on this?

          Show
          rakeshr Rakesh Roy (Inactive) added a comment - Jennifer Leugers Is there anything pending from our side on this?
          Hide
          jennifer.leugers Jennifer Leugers added a comment -

          I think we are good with the exception of the questions posed on the Safe Harbors setting. Can you get developments feedback on the below questions:

          • If W-2 is selected - the employee level W-2 earnings field needs to be filled in. Is this accurate?
          • If FPL is selected - no Salary or W2 data is needed at EE level. Is this accurate?
          • If Rate of Pay is selected - only the value selected (Ben Salary, Gross Annual Salary or W2) needs to be loaded at EE level. Is this accurate?
          Show
          jennifer.leugers Jennifer Leugers added a comment - I think we are good with the exception of the questions posed on the Safe Harbors setting. Can you get developments feedback on the below questions: If W-2 is selected - the employee level W-2 earnings field needs to be filled in. Is this accurate? If FPL is selected - no Salary or W2 data is needed at EE level. Is this accurate? If Rate of Pay is selected - only the value selected (Ben Salary, Gross Annual Salary or W2) needs to be loaded at EE level. Is this accurate?
          Hide
          nandkumar Nandkumar Prabhakar Karlekar (Inactive) added a comment -

          If W-2 is selected - the employee level W-2 earnings field needs to be filled in. Is this accurate?
          Answer: Yes, if this field is null or not filled then system will refer the selected salary field from the ACA Paramater..

          If FPL is selected - no Salary or W2 data is needed at EE level. Is this accurate?
          *Answer *: Correct .

          If Rate of Pay is selected - only the value selected (Ben Salary, Gross Annual Salary or W2) needs to be loaded at EE level. Is this accurate?
          *Answer *: Correct, if you load the Rate type and current rate then this will get priority . If it is null then system will refer the selected salary field from the ACA Paramater.

          Show
          nandkumar Nandkumar Prabhakar Karlekar (Inactive) added a comment - If W-2 is selected - the employee level W-2 earnings field needs to be filled in. Is this accurate? Answer : Yes, if this field is null or not filled then system will refer the selected salary field from the ACA Paramater.. If FPL is selected - no Salary or W2 data is needed at EE level. Is this accurate? *Answer *: Correct . If Rate of Pay is selected - only the value selected (Ben Salary, Gross Annual Salary or W2) needs to be loaded at EE level. Is this accurate? *Answer *: Correct, if you load the Rate type and current rate then this will get priority . If it is null then system will refer the selected salary field from the ACA Paramater.
          Hide
          rakeshr Rakesh Roy (Inactive) added a comment -

          Jennifer Leugers Please check and confirm.

          Show
          rakeshr Rakesh Roy (Inactive) added a comment - Jennifer Leugers Please check and confirm.
          Hide
          jennifer.leugers Jennifer Leugers added a comment -

          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.

          Show
          jennifer.leugers Jennifer Leugers added a comment - 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.
          Hide
          nandkumar Nandkumar Prabhakar Karlekar (Inactive) added a comment -

          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.

          Show
          nandkumar Nandkumar Prabhakar Karlekar (Inactive) added a comment - 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.
          Hide
          jennifer.leugers Jennifer Leugers added a comment -

          Nandkumar Prabhakar Karlekar

          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.

          Show
          jennifer.leugers Jennifer Leugers added a comment - Nandkumar Prabhakar Karlekar 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.
          Hide
          nandkumar Nandkumar Prabhakar Karlekar (Inactive) added a comment -

          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

          Show
          nandkumar Nandkumar Prabhakar Karlekar (Inactive) added a comment - 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

            People

            Assignee:
            jennifer.leugers Jennifer Leugers
            Reporter:
            jennifer.leugers Jennifer Leugers
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              Dates

              Created:
              Updated:
              Resolved: