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  1. WORKTERRA
  2. WT-8884

2017 ACA - ACA reporting files for Wheaton (Tango)

    Details

    • Type: Enhancement
    • Status: Closed
    • Priority: Medium
    • Resolution: Done
    • Affects Version/s: None
    • Fix Version/s: None
    • Component/s: ACA
    • Labels:
      None
    • Module:
      ACA - Reports
    • Reported by:
      Support
    • Company:
      Wheaton Franciscan Healthcare
    • Severity:
      Medium

      Description

      Please see Kim at BSG's questions below and let us know your feedback:

      During our call today there were some items discussed that I we needed for Workterra to produce the monthly files for 2017.
      Plan IDs for 2017 will change. They will be WHDHP and WPPO. I have attached the 6 Medical Plan names in WT to provide any clarification needed.
      screenshot-2.png
      There is another area that will need to be programmed differently and possibly discussed regarding Field 31 on the DEM file. In 2017, the Ascension plans moved to a Premium Structure based on Salary bands. 4 salary bands were built for 2017 and associated rates were also built in the WT system to determine the proper premium based on the salary. The Minimum Coverage Amount value will be based on these premiums driven by Salary band, but it will only populate the value for the Single HDHP in that salary band.
      For example, someone enrolled in the Family PPO plan for January 2017, earning $34,000 would be in Salary band 1. Their monthly premium in WT would be $335.83, but the amount that would need to report in Field 31 would be 80.17 (single HDHP premium) – HDHP Less than 35006 Sub Rate Name, Employee Pre Tax Cost Associate Only Health Tier.
      It gets a bit more complicated when the Ascension Socially Just (Premium Assistance) program comes into plan. This is a program providing a rate reduction (25%, 50%, 75% or 100%) which is captured in a UDF at the Employee Demographic screen (2017 Medical Subsidy), this reduction would then need to be applied to the above amount. There are approximately 375 employees in this Socially Just program.
      These changes are very different from the 2016 data, which was a static amount. Can you let me know your thoughts on this and if this would be possible in development? Since we are only providing this report for 4 months, if there is a better way to do this due to development process potentially being extensive, please let me know.
      I am still working to finalize all of the rates for those in the Socially Just program. I do have the rates for those based on the Salary Bands
      Band 1 under 35006 $80.17
      Band 2 35006 to 75006 $112.67
      Band 3 75006.01 to 150010 $147.34
      Band 4 over 150010.00 $179.84
      Please let me know if you would like to discuss this to make sure you have a full understanding of this project for 2017.

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            In Production Testing Production Complete
            49s 1
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            Production Complete Closed
            3s 1

              People

              Assignee:
              Van.Nguyen Van Nguyen (Inactive)
              Reporter:
              smita.pawar Smita Pawar (Inactive)
              EDI Analyst 1:
              Van Nguyen (Inactive)
              Votes:
              0 Vote for this issue
              Watchers:
              4 Start watching this issue

                Dates

                Created:
                Updated:
                Resolved:

                  Time Tracking

                  Estimated:
                  Original Estimate - 88h Original Estimate - 88h
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