-
Type:
Support Activity
-
Status: Resolved
-
Priority:
High
-
Resolution: Done
-
Affects Version/s: None
-
Fix Version/s: None
-
Component/s: None
-
Labels:None
-
Support Task Type:Configuration
-
Environment:Production
-
Reported by:Client
-
Module:BenAdmin - Export
-
Severity:Complex
Hello,
HR Simplified advised that three LOA events were reported to them with a qualifying event of "DC" which is loss of dependent status due to dependent becoming overaged. No coverage level (i.e. single, family) was reported on the file feed. When benefits are terminated due to leave of absence, they should have a qualifying event code of 'RH' - reduction in hours.
Below are 3 examples of where this occurred for CHMC employees (breakout of Prime_Healthcare):
Maria Samaniego-Marin EEID997973
Cynthelia James EEID250554
Jennifer Leavell EEID516738
Please check the coding on the HR Simplified file feed for these CHMC employees, as well as all of the Prime_Healthcare facilities:
AH
CHMC
EHMC
HMC
Hospitality
KMC
MHIN
PMC
Prime_Healthcare
SRMC
Thank you,
Amber
- relates to
-
WT-8580 Cobra Coverage Tiers are not rolling out for multiple cobra event(valid)
-
- Closed
-
Hello,
CHMC employee Adrian Torres EEID546070 terminated on 3/20/2017. HR Simplified confirmed that the employee's qualifying event was received on the COBRA file, but no benefits were listed.
The employee had the following active benefits:
Low PPO – EE+ Family
Metlife PPO Dental – EE+SP
VSP – EE Only
Please research. Please confirm that the coding for ALL HR Simplified files was reviewed for every+underlined text+ Prime facility listed in the ticket. Client is not happy that the same coding issues are occurring. I am also reattaching the HR Simplified Account Structure for 2017.
Thank you.
Amber
Hi Amber Love-Jones,
We have crossed check the CHMC employee Adrian Torres EEID546070 terminated on 3/20/2017 and below are our observation:
Adrian Torres was enrolled into following plans
Low PPO – EE+ Family
Metlife PPO Dental – EE+SP
VSP – EE Only
1. For Metlife PPO Dental and VSP plans
The termination date is set as never effective for these plans. We have checked this from Partner login >> CHMC >> search EE >> view history
Due to which these plans did not reflect on export files.
(Please refer screen shot Metlife and VSP.png)
2. For Low PPO
Employee data for this plan change was changed on 3/23/2017 on 3:15:53 PM (refer screen shot Low PPO.png) and the export file “Prime Healthcare_NEW HRSimplifed_COBRA Coverage_Group” was schedule on 3/23/2017 at 3:04:26 PM
(refer screen shot export.png)
Due to which this benefit “Low PPO Plan" did not get reflected on export file for this employee, it will get reflected on next export file.
Do let us know if you have any queries. Thank you!
------------------------------------------------------------------------------------------------
CC: Mandar Kulkarni, Vijay Siddha, Jaideep Vinchurkar,
Sumeet.Kolge (Inactive)
added a comment - - edited Hi Amber Love-Jones ,
We have crossed check the CHMC employee Adrian Torres EEID546070 terminated on 3/20/2017 and below are our observation:
Adrian Torres was enrolled into following plans
Low PPO – EE+ Family
Metlife PPO Dental – EE+SP
VSP – EE Only
1. For Metlife PPO Dental and VSP plans
The termination date is set as never effective for these plans. We have checked this from Partner login >> CHMC >> search EE >> view history
Due to which these plans did not reflect on export files.
(Please refer screen shot Metlife and VSP.png )
2. For Low PPO
Employee data for this plan change was changed on 3/23/2017 on 3:15:53 PM (refer screen shot Low PPO.png) and the export file “Prime Healthcare_NEW HRSimplifed_COBRA Coverage_Group” was schedule on 3/23/2017 at 3:04:26 PM
(refer screen shot export.png )
Due to which this benefit “Low PPO Plan" did not get reflected on export file for this employee, it will get reflected on next export file.
Do let us know if you have any queries. Thank you!
------------------------------------------------------------------------------------------------
CC: Mandar Kulkarni , Vijay Siddha , Jaideep Vinchurkar , Hello Sumeet,
St. Marys Regional Med. Ctr employee Melissa Galina (EEID186678) is on LOA effective 5/13/17. Employee's information went over on the HR Simplified file as:
xxx-xx-6526,DELPPO,PPO 1200,Sgl
xxx-xx-6526,VSP,Sign C Plan,Sgl
xxx-xx-6526,STMARY,PPO Low,Sgl
Employee is enrolled in the following (attached) plan in Workterra:
Please review and advise. We are continuing to experience problems with employees on LOA on the HR Simplified files; this needs to be resolved immediately.
Thank you,
Amber
Hi Amber Love-Jones,
Below are the 3C's
Concern : Wrong values sent on coverage feed.
Cause : There were wrong data transformation saved for for fields Key 1 Carrier and Key 2 Coverage. and this records are exported on 05/18/2017.
Correction : Chris Ellenberger have changed data transformation for the above fields on 05/30/2017. This will not be an issue going forward.
Please let us know if you required more information on this.
With kind regards,
Rajendra Pawar
-------------------------------------------------
Vinayak Kulkarni Ganesh Sadawarte
Hi Amber Love-Jones,
Thank you for your reply.
I am closing this ticket for now. Do reopen this, in case this issue reoccurs. Thanks.
---------------------------------------
CC: Vijay Siddha, Mandar Kulkarni