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  1. WORKTERRA
  2. WT-8690

Prime_Healthcare: HR Simplified Qualifying Events

    Details

    • 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

      Description

      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

        Attachments

          Issue Links

            Activity

            alov Amber Love-Jones (Inactive) created issue -
            rakeshr Rakesh Roy (Inactive) made changes -
            Field Original Value New Value
            Module Parent values: BenAdmin(10100) Parent values: BenAdmin(10100)Level 1 values: EDS(10108)
            rakeshr Rakesh Roy (Inactive) made changes -
            Module Parent values: BenAdmin(10100)Level 1 values: EDS(10108) Parent values: BenAdmin(10100)Level 1 values: Export(10110)
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Link This issue relates to WT-8550 [ WT-8550 ]
            Hide
            sumeet.kolge Sumeet.Kolge (Inactive) added a comment - - edited

            Hello Amber Love-Jones,

            We had a discussion with development team and this issue has been already reported in JIRA ticket WT-8580 and its been worked upon by development team.

            I will keep a watch on WT-8580, once its done. I will update this ticket as well.

            Should you have any further queries, please let us know. Thank you!
            ---------------------------------------------------------------------------
            CC:Mandar Kulkarni,Vijay Siddha, Prajakta Belhe

            Show
            sumeet.kolge Sumeet.Kolge (Inactive) added a comment - - edited Hello Amber Love-Jones , We had a discussion with development team and this issue has been already reported in JIRA ticket WT-8580 and its been worked upon by development team. I will keep a watch on WT-8580 , once its done. I will update this ticket as well. Should you have any further queries, please let us know. Thank you! --------------------------------------------------------------------------- CC: Mandar Kulkarni , Vijay Siddha , Prajakta Belhe
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Assignee Mandar Kulkarni [ mandark ] Amber Love-Jones [ alov ]
            sumeet.kolge Sumeet.Kolge (Inactive) logged work - 03/Mar/17 12:20 PM
            • Time Spent:
              1.3h
               

              analysed the issue and discussed with development teams.

            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Remaining Estimate 0h [ 0 ]
            Time Spent 1.3h [ 4680 ]
            Worklog Id 28831 [ 28831 ]
            Hide
            alov Amber Love-Jones (Inactive) added a comment -

            Thank you for the update, [~Sumeet].

            Amber

            Show
            alov Amber Love-Jones (Inactive) added a comment - Thank you for the update, [~Sumeet] . Amber
            alov Amber Love-Jones (Inactive) made changes -
            Assignee Amber Love-Jones [ alov ] Sumeet.Kolge [ sumeet.kolge ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Link This issue relates to WT-8550 [ WT-8550 ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Link This issue relates to WT-8580 [ WT-8580 ]
            Hide
            sumeet.kolge Sumeet.Kolge (Inactive) added a comment -

            Hello Amber Love-Jones,

            The issue WT-8580 which is related to WT-8690 is been verified and fixed on production could you please Check and verify at your end.

            Please let us know if you have any queries. Thank you!

            -------------------------------------------------------------------------------
            CC:Mandar Kulkarni,Vijay Siddha

            Show
            sumeet.kolge Sumeet.Kolge (Inactive) added a comment - Hello Amber Love-Jones , The issue WT-8580 which is related to WT-8690 is been verified and fixed on production could you please Check and verify at your end. Please let us know if you have any queries. Thank you! ------------------------------------------------------------------------------- CC: Mandar Kulkarni , Vijay Siddha
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Assignee Sumeet.Kolge [ sumeet.kolge ] Amber Love-Jones [ alov ]
            Hide
            alov Amber Love-Jones (Inactive) added a comment -

            Hello [~Sumeet],

            I am unable to verify coding updates/changes on the HR Simplified file feed as I do not have coding experience. I have alerted HR Simplified to advise once they receive weekly file feeds from WT.

            Thank you.

            Amber

            Show
            alov Amber Love-Jones (Inactive) added a comment - Hello [~Sumeet] , I am unable to verify coding updates/changes on the HR Simplified file feed as I do not have coding experience. I have alerted HR Simplified to advise once they receive weekly file feeds from WT. Thank you. Amber
            alov Amber Love-Jones (Inactive) made changes -
            Assignee Amber Love-Jones [ alov ] Sumeet.Kolge [ sumeet.kolge ]
            Hide
            sumeet.kolge Sumeet.Kolge (Inactive) added a comment -

            Hello Amber Love-Jones

            We have discussed and cross checked the scenarios with development and QA teams for LOA and for RH' - reduction in hours, The system is working fine as expected.

            Could you please verify the above mentioned scenarios from UI / Customization?

            Please do let us know if you have queries. Thank you!

            ------------------------------------------------------------------------------------------
            CC:Mandar Kulkarni,Vijay Siddha

            Show
            sumeet.kolge Sumeet.Kolge (Inactive) added a comment - Hello Amber Love-Jones We have discussed and cross checked the scenarios with development and QA teams for LOA and for RH' - reduction in hours, The system is working fine as expected. Could you please verify the above mentioned scenarios from UI / Customization? Please do let us know if you have queries. Thank you! ------------------------------------------------------------------------------------------ CC: Mandar Kulkarni , Vijay Siddha
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Assignee Sumeet.Kolge [ sumeet.kolge ] Amber Love-Jones [ alov ]
            sumeet.kolge Sumeet.Kolge (Inactive) logged work - 13/Mar/17 10:33 AM
            • Time Spent:
              2h
               

              Discussed With dev and QA teams

            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Time Spent 1.3h [ 4680 ] 3.3h [ 11880 ]
            Worklog Id 30550 [ 30550 ]
            rakeshr Rakesh Roy (Inactive) made changes -
            Status Open [ 1 ] In Development [ 10007 ]
            rakeshr Rakesh Roy (Inactive) made changes -
            Status In Development [ 10007 ] Local Testing [ 10200 ]
            rakeshr Rakesh Roy (Inactive) made changes -
            Status Local Testing [ 10200 ] Stage Testing [ 10201 ]
            rakeshr Rakesh Roy (Inactive) made changes -
            Status Stage Testing [ 10201 ] Production Testing [ 10202 ]
            rakeshr Rakesh Roy (Inactive) made changes -
            Resolution Fixed [ 1 ]
            Status Production Testing [ 10202 ] Production Complete [ 10028 ]
            Hide
            alov Amber Love-Jones (Inactive) added a comment -

            Hello Sumeet.Kolge,

            As mentioned, I do not know how I would verify coding changes made to a file feed. I have not received any additional discrepancies from HR Simplified, so at this point, I believe this issue has been resolved. I will reopen the ticket if any other instances such as this take place.

            Thank you,

            Amber

            Show
            alov Amber Love-Jones (Inactive) added a comment - Hello Sumeet.Kolge , As mentioned, I do not know how I would verify coding changes made to a file feed. I have not received any additional discrepancies from HR Simplified, so at this point, I believe this issue has been resolved. I will reopen the ticket if any other instances such as this take place. Thank you, Amber
            alov Amber Love-Jones (Inactive) made changes -
            Assignee Amber Love-Jones [ alov ] Sumeet.Kolge [ sumeet.kolge ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Status Production Complete [ 10028 ] Closed [ 6 ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Status Closed [ 6 ] Reopen in Production [ 10027 ]
            Hide
            sumeet.kolge Sumeet.Kolge (Inactive) added a comment - - edited

            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

            Show
            sumeet.kolge Sumeet.Kolge (Inactive) added a comment - - edited 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
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Status Reopen in Production [ 10027 ] In Development [ 10007 ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Status In Development [ 10007 ] Local Testing [ 10200 ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Status Local Testing [ 10200 ] Stage Testing [ 10201 ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Status Stage Testing [ 10201 ] Production Testing [ 10202 ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Status Production Testing [ 10202 ] Production Complete [ 10028 ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Status Production Complete [ 10028 ] Closed [ 6 ]
            Hide
            alov Amber Love-Jones (Inactive) added a comment -

            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

            Show
            alov Amber Love-Jones (Inactive) added a comment - 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
            alov Amber Love-Jones (Inactive) made changes -
            Status Closed [ 6 ] Reopen in Production [ 10027 ]
            alov Amber Love-Jones (Inactive) made changes -
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Status Reopen in Production [ 10027 ] In Development [ 10007 ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Status In Development [ 10007 ] Local Testing [ 10200 ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Status Local Testing [ 10200 ] Stage Testing [ 10201 ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Status Stage Testing [ 10201 ] Production Testing [ 10202 ]
            Hide
            sumeet.kolge 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,

            Show
            sumeet.kolge 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 ,
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Assignee Sumeet.Kolge [ sumeet.kolge ] Amber Love-Jones [ alov ]
            Status Production Testing [ 10202 ] Production Complete [ 10028 ]
            sumeet.kolge Sumeet.Kolge (Inactive) made changes -
            Time Spent 3.3h [ 11880 ] 6.3h [ 22680 ]
            Worklog Id 34291 [ 34291 ]
            sumeet.kolge Sumeet.Kolge (Inactive) logged work - 29/Mar/17 09:19 PM
            • Time Spent:
              3h
               

              Analysis and discussion with team.

            alov Amber Love-Jones (Inactive) made changes -
            Attachment screenshot-1.png [ 50318 ]
            Hide
            alov Amber Love-Jones (Inactive) added a comment -

            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

            Amit Thorve

            Show
            alov Amber Love-Jones (Inactive) added a comment - 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 Amit Thorve
            alov Amber Love-Jones (Inactive) made changes -
            Assignee Amber Love-Jones [ alov ] Sumeet.Kolge [ sumeet.kolge ]
            jaideep.vinchurkar Jaideep Vinchurkar (Inactive) made changes -
            Assignee Sumeet.Kolge [ sumeet.kolge ] Vinayak Kulkarni [ vinayak.kulkarni ]
            Vinayak.Kulkarni Vinayak Kulkarni (Inactive) made changes -
            Assignee Vinayak Kulkarni [ vinayak.kulkarni ] Rajendra Pawar [ rajendra.pawar ]
            rajendra.pawar Rajendra Pawar (Inactive) logged work - 02/Jun/17 01:46 PM
            • Time Spent:
              1h
               
              <No comment>
            Hide
            rajendra.pawar Rajendra Pawar (Inactive) added a comment - - edited

            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

            Show
            rajendra.pawar Rajendra Pawar (Inactive) added a comment - - edited 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
            rajendra.pawar Rajendra Pawar (Inactive) made changes -
            Time Spent 6.3h [ 22680 ] 7.3h [ 26280 ]
            Worklog Id 52007 [ 52007 ]
            rajendra.pawar Rajendra Pawar (Inactive) made changes -
            Assignee Rajendra Pawar [ rajendra.pawar ] Amber Love-Jones [ alov ]
            rajendra.pawar Rajendra Pawar (Inactive) made changes -
            Issue Type Bug [ 1 ] Support Activity [ 10301 ]
            Status Production Complete [ 10028 ] Resolved [ 5 ]
            Support Task Type Customization [ 11204 ]
            Workflow WT_Defects [ 33722 ] WT_Support [ 43421 ]
            Vinayak.Kulkarni Vinayak Kulkarni (Inactive) made changes -
            Dev Due Date 02/Jun/2017
            Original Estimate 0h [ 0 ]
            satyap Satya made changes -
            Environment_New Production [ 18442 ]
            Transition Time In Source Status Execution Times
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              People

              Assignee:
              alov Amber Love-Jones (Inactive)
              Reporter:
              alov Amber Love-Jones (Inactive)
              Account Executive:
              Amber Love-Jones (Inactive)
              Votes:
              0 Vote for this issue
              Watchers:
              3 Start watching this issue

                Dates

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                Resolved:
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