Estimation is 3 dev for 25 days

WT-3438 BSG : - ADP Health Compliance Benefits Import Pipe Delimited-2.51
Analysis Completed and development is in progress.

WT-3441 BSG ADP Health Compliance Non Employee Import 2.52
Analysis is in progress will share the complete plan before 15 July

WT-3440 BSG ADP Health Compliance Benefit Import XML v2.42 XML
This JIRA IS currently in Queue for Analysis. No Any comment are available for this

We have 10 different formats for BSG and only we have selected the above 3 as of now and started development on the WT-3438

ASSUMPTIONs:

Hi Debbie Kulling,

Please confirm the Assumptions, we are building the ACA files on this assumptions.

These client will add the Waiver plan in the system which indicate the coverage is waived and not using the benefit Type.

System will export all the employee who enrolled in medical plan or waiver plan.
If the employee is not enrolled in any medical or waiver plan then this will not get exported on the File.

Input needed.
Need to add one input on plan design which indicate the waiver Plan

Please let me know you Inputs on this .

Hi Debbie Kulling

Can you Please review the attached document "ACA Eligibility and Event Processing queries for BSG files.". whave documented all our assumptions and queries.
BSG Questions.docx

Please review our assumptions and let us know you confirmation.

If possible can you please arrange a call with BSG and include Amit Thorve and Nandkumar Prabhakar Karlekar in the same call so we will discuss the same with BSG EDI Person.

CC: Steve Allison,David Rhodes

Thanks
Nandkumar

Sachin Hingole Smita Pawar Mahendra Mungase Rakesh Roy Yogesh Chaudhari Nandkumar Prabhakar Karlekar

Hi,

Please map the "Send only one record per member on rowwise" indicato on Coverage & waive template.
Reference files : COID_NETSECUREID_BenefitsImport_20160818_165505_Beforemapping.txt COID_NETSECUREID_BenefitsImport_20160818_183422_Aftermappingsendonlyonerecord per member.txt

Regards,
Revan

Mail Subject -"RE: Valmet ACA Files"

This chart shows the Lowest Cost Employee Only Plans offered the individuals.

421 were offered a plan costing them 102.16 per month and 866 a plan that costs 36.20 per month.

Now notice that the 4 persons who were offered a “lowest cost ee only plan meeting MEC & MVP” at a cost of 3.19.07 seem to be “Retiree” participants.

Are these four individuals retirees?

[Harbinger] - We have observed that there are only two employee instead of four employee.Both employees getting two events. Due to this it's looking there are 4 employees. Are these individuals retirees? - Currently both employee status is - Deceased but previously both were retired. Please find below details for his demographics.

1.Smith Lila - We observed that employee status was retiree for 01/01/2016 to 05/12/2016.

Currently status is Diseased effective from 05/13/2016.

2.Towne Emily - We observed that employee status was retiree for 01/01/2016 to 02/03/2016

Currently status is Diseased effective from 02/04/2016

The plans do look good. I see that the plans are not “self-insured”. I just want to make sure that that is correct.

[Harbinger] -As per customization, Only "HIGHMARK RETIREE PPO 80" is self insured plan out of 4 mentioned plan.

Again, let me explain that the “multi-employer file” is a way to list those individuals that you can easily exclude from having to report benefits for, because they have their benefits through the union agreement.

[Harbinger] - There are 18 employees under union code - P003- Federal Way. These employees are neither enrolled nor waived so need to configure default waive benefit type so these employees will get waived entries from 01/01/2016 and will be reflected on the file.

You probably have retiree’s on this current file, but that should not necessarily be a problem. The important thing is to make sure that all active eligible employees have a record of an offer for the plan year (for the time of their eligibility). The Retirees or non-employees are simply those for whom the client is not responsible according to ACA for having to provide coverage (since these participants are not full-time). Generally these come on anther file—which is simpler—but I don’t see a problem if they do come on this file.

[Harbinger] - As per the email Subject : "Valmet ACA Files" We are exported the file with below communication..

" Multi-Employer file should include Federal Way Union employees with Union Code P003

*Non-Employee File should include:

o Status = COBRA

o Status = Retired w/work location RETF – Fort Edwards or RETA – Appleton

o PPPSEV or PPPVESP it appears these individuals have an Active status in WorkTerra (WT)? I’m not sure why but they can be identified by looking at

their WT SubStatus code = PPPSEV or PPPVESP_EE or PPPVESP_SP"

*

I hope this helps.

Please help me understand the “Qualifying Event – Admin Change” which is coming over as another “OFFR” (Offer) but has the same date as the Open Enrollment Event. It seems to me like these are identical and are overwriting them to create one coverage. Should it show a change in coverage? Or is it just one coverage?

[Harbinger] - It is just one coverage only difference is employee getting same offer by two different event. “Qualifying Event – Admin Change” this event raised for testing purpose only.

For instance, Joshua Bailey has an Open Enrollment and Qualifying Event –Admin Change which results in one Coverage. That seems like a lot of data given to document one converage. Does that question make sense?

*[Harbinger] - Below are the explanation for why lot of data for one coverage on export file.

1.Employee getting same offer by two different event - Qualifying Event - Admin Change , Open Enrollment.

“Qualifying Event – Admin Change” this event raised for testing purpose only.

2.In ELIG - sub template we are showing tier wise cost for plan.
*

Hi Debbie Kulling,

Please find attached document Multi&Non-Employee.docx with this JIRA.
This document has explanation for handling Multi-Employee, Non-Employee and Active employees using plan design.

Request you to confirm/ suggest any changes to handle all (Multi-Employer, Non-Employer or Employee) ADP files.

Please let us know if you need any other details.

Thanks,
Sachin Hingole

Nandkumar Prabhakar Karlekar shyam sharma Rakesh Roy Yogesh Chaudhari Revansiddha Gaur Smita Pawar Mahendra Mungase

Hi Debbie Kulling,

Any updates on above comments?

Thanks,
Sachin Hingole

Nandkumar Prabhakar Karlekar shyam sharma Rakesh Roy Yogesh Chaudhari Revansiddha Gaur Smita Pawar Mahendra Mungase

Received reply for 1st test file for non employee file

Here are some of the format issues:

ADDR
Starting from the end of the line, the country codes are 2 digit max. not “USA” but “US”.
If the country is “US” the zip is 5 digits, and the Zip code extension (optional) is limited to 4 digits.

COVG
Medical Coverage Level Code is limited to 20 characters. “ Employee + Spouse + Children” is too long.

EEID
Four cases of missing NonEmployee Type (C, R, or O are required.)

EEID John M Lemieux seems to be missing quite a bit of information. He would fail.

Hi Debbie,

We have fixed previously mentioned issue for Non employee ACA file.
After fixing issues we have exported latest files for non employee from Valmet company.

We have uploaded non employee test files on FTP.

FTP details are as follows

URL - https://ftpsecure.ebsbenefits.com
Folder path- /users/workterraaca/BSG ACA/Valmet ADP File/NonEmployee/10262016
File name- G32B64JRY120CY5E_valmet1_NonEmployee_20160101_054640.zip

Previous Issues are as follows

ADDR
Starting from the end of the line, the country codes are 2 digit max. not “USA” but “US”.
If the country is “US” the zip is 5 digits, and the Zip code extension (optional) is limited to 4 digits.
Harbinger Comments - Now country code field will show only 2 chars i.e. US. and also zip codes will show 5 digits and extension will show 4 digits.

COVG
Medical Coverage Level Code is limited to 20 characters. “ Employee + Spouse + Children” is too long.
Harbinger Comments - We have corrected it by changing data transformation, it will not exceed 20 chars for Medical Coverage Level Code.

EEID
Four cases of missing NonEmployee Type (C, R, or O are required.)
Harbinger Comments - This is also fixed by changing data transformation, File will show only C, R or O.

EEID John M Lemieux seems to be missing quite a bit of information. He would fail.
Harbinger Comments - For employee John M Lemieux, as he was enrolled in active plans before his change of status and as active plans are not selected on the template. This employee is not on the file.

Hi Nandkumar Prabhakar Karlekar,

As discussed attached BSG-InternalTracking.xls excel having current status of BSG group files.

Thanks,
Sachin Hingole

Yogesh Chaudhari Revansiddha Gaur Mahendra Mungase

Attaching test cases for BSG enhancement.

attached updated BSG-InternalTracking.xls excel for Valmet change and Tango files.

Nandkumar Prabhakar Karlekar Revansiddha Gaur Mahendra Mungase Yogesh Chaudhari

As Currently using WT-8973 for metso ACA file and now we are not delivering file
for Valmet and Tango. Please refer WT: 8973 for 2017 metso ACA files updates.

Hence we are closing this ticket. Please feel free to reopen ticket if required.

Thanks,
Smita