PUT ON HOLD. Discussing internally about this requirement.

For manual export, need a flag "Don't send terminations". If set to "true", the export will exclude all the records that have termination dates on them.

Note: we also need to check if we have situations where terminations before certain date are to be excluded. Also - just as we have "sent termination once" - some carriers have asked for terminations to be sent more than once, and also for a specific duration. Need to check that requirement too.

This enhancement is needed to handle problems associated with communicating PCP after open enrollment. Following is a typical scenario that explains current practice and resulting problem.

An OE file is required to be sent to the carrier. It is for calendar year 2018 in this example.The requirements are as follows.

• Need to have all the records that are active in the next year i.e. 2018.
• There should be no records that are terminated. (If records are term’ed on or before 12/31/2017, carrier resorts to "terminating by omission" for the new year.)
• The new records (that are effective 1/1/2018) must have PCP.
• The rolled over records (with effective date prior to 1/1/2018) should not have PCP.

When OE file is exported manually, it contains (a) new records (with PCP), (b) rolled over records (with no PCP) and (c) also the records that are term’ed before 12/31/2017.

As stated in the requirement, we need to exclude (c ) above. For that purpose, OE file is exported again manually. With “Send term once” flag on, it excludes the term’ed records. However, this step drops the PCP from the new records – as according to run date maintenance, these records were sent once before.

The workaround is to have development extract PCP on the new records.

Solution (This enhancement)
We can achieve the desired result with just one export using the new flag "Don't send terminations" on. Here the export will exclude all the records that have termination date on them. Such records will be "terminated by omission" by the carrier. Only the new records (1/1/2018) will have the PCP. Rolled over records will not have PCP.

Caveat
If for any reason there are rolled over records that are terminated in the year 2018 (let's say term'ed on 2/3/2018) - these will NOT go on the file. These will have to be communicated to the carrier separately. If the carrier is OK with receiving records that are terminated in the future, we could have a parameter "Don't send terminations before" and set it to 1/1/2018. But this is supposed to be rare case.

CC Van Nguyen Cindy Wibbing Chris Ellenberger Damion M Velasquez Amit Thorve Satya Samir Vinayak Kulkarni