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Type:
Bug
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Status: Closed
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Priority:
High
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Resolution: Unresolved
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Affects Version/s: None
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Fix Version/s: None
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Component/s: BenAdmin
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Labels:None
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Environment:Stage
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Bug Type:Functional
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Bug Severity:Medium
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Module:BenAdmin - Report
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Reported by:Client
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Company:City of Santa Rosa
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Item State:Production Complete - Closed
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Sprint:WT Sprint 32-Bugs
Please see the issue below. I have attached the pre bill and the steps they followed. Please correct the billing table
The Active Anthem rates are Self Insured. Two of the component’s rates needed to be changed back to 5/1 (when BCC took over the group). I went into the system and successfully adjusted the rates for all Active Anthem plans. I ran the August Invoice to make sure all adjustments (May – July) would be accounted for. While reviewing the July Adjustments I noticed that if an individual had a future term date in the system (ie: the group went into the system 6/20 and put in a termination date of 7/7 for an EE) the system correctly credited the EE but never re-billed the Medical rate for July. This affected 4 Employees:
Debra Bagley
Harry Cheng
Judy Maral
Mitchell Moore
- is cloned by
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- Closed
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Hi Debbie Kulling,
There was some script changes required which we have done in this company on stage only. As per process, code fix will go on LB environment on Wednesday .
The issue for Debra Bagley and Harry Cheng has been fixed with the script change.
We didn't find any issue for Judy Maral and Mitchell Moore. They are getting proper adjustments for July.
Kelly Barnard has correct record in invoice for May adjustment. As per system data ,this employee does not have cost for May. So she is getting returns only.
Please verify at your end and let us know if any issue persists.
Thanks,
Jyoti Agrawal
Jyoti Agrawal (Inactive)
added a comment - Hi Debbie Kulling ,
There was some script changes required which we have done in this company on stage only. As per process, code fix will go on LB environment on Wednesday .
The issue for Debra Bagley and Harry Cheng has been fixed with the script change.
We didn't find any issue for Judy Maral and Mitchell Moore . They are getting proper adjustments for July.
Kelly Barnard has correct record in invoice for May adjustment. As per system data ,this employee does not have cost for May. So she is getting returns only.
Please verify at your end and let us know if any issue persists.
CC: Prasanna Karlekar
Thanks,
Jyoti Agrawal The client ran the bill today and the employees are still not correct. See comments below
The issue for Debra Bagley and Harry Cheng has been fixed with the script change. This is not correct based on the invoice we ran at 2:30 Eastern today. Only showing the credit not the positive re-billing.
We didn't find any issue for Judy Maral and Mitchell Moore. They are getting proper adjustments for July. Judy switched to retiree status on 7/7/2017 but coverage extended to the end of month. Her retiree plans did not start until 8/1/2017. The system did the correct adjustments for May and June. July only gave a credit of $842.00, but should have also done a billing for $842.00. This adjustment transaction was unrelated to the status change. The Adjustment for May, June and July was related to an allocation correction in the self-funded components. The system is doing it correctly for May and June. The only thing that could be causing the issue for July is the status change. Please have them take a look. Mitchell is a similar situation to Maral, but the status change was to terminated instead of Retiree. He terminated on 7/3/2017 and his benefits extended to 7/31/2017. Again May and June adjustments are correct. Only July is wrong.
Kelly Barnard has correct record in invoice for May adjustment. As per system data ,this employee does not have cost for May. So she is getting returns only. Kelly’s medical coverage was terminated on 5/31/2017. The self-funded allocation correction we were trying to do is only crediting May and not re-billing the positive side. We need a positive $1175.00 for May on the August invoice.
Hi Debbie Kulling,
As per environment mentioned in this ticket, we did changes on Stage. What ever analysis mentioned in my above comment was per Stage data.
We just cross checked today on production and found that client tested invoice on production.
We made changes in production today. Issue for Debra Bagley, Harry Cheng,Judy Maral, Mitchell Moore is resolved now. They will get positive re-billing.
Regarding Kelly Barnard, after her status changed to Terminated she got ineligible for the plan and rate as per eligibility rule set in both.
She was billed on earlier invoice for the month of May with cost $1175.00. After becoming ineligible for rate 'Anthem PPO 1500' , cost assigned to her got termed as never effective and as of now there is no cost assigned to her for May 2017. Hence only returns are appearing.
We also verified the record from Enrollment report. She is not getting cost for May 2017. See the attached image. 
Regards,
Jyoti Agrawal
Jyoti Agrawal (Inactive)
added a comment - Hi Debbie Kulling ,
As per environment mentioned in this ticket, we did changes on Stage. What ever analysis mentioned in my above comment was per Stage data.
We just cross checked today on production and found that client tested invoice on production.
We made changes in production today. Issue for Debra Bagley, Harry Cheng,Judy Maral, Mitchell Moore is resolved now. They will get positive re-billing.
Regarding Kelly Barnard, after her status changed to Terminated she got ineligible for the plan and rate as per eligibility rule set in both.
She was billed on earlier invoice for the month of May with cost $1175.00. After becoming ineligible for rate 'Anthem PPO 1500' , cost assigned to her got termed as never effective and as of now there is no cost assigned to her for May 2017. Hence only returns are appearing.
We also verified the record from Enrollment report. She is not getting cost for May 2017. See the attached image.
CC: Prasanna Karlekar
Regards,
Jyoti Agrawal Below are 3C's :-
Concern :- Incorrect adjustment when there is cost change and election termination on mid of same month.
Cause :- Billing policies were not handled properly for mid month term and cost change on same month
Correction :- Handled above scenario
Affected Areas :-
All retro term adjustment
Affected File :- OES_SP_GetRetroBillingDetails_InvoiceBenefitWise
Tested Scenarios :-
Retro term and cost change on same month
1) Mid month term - on month equal to billing month
2) Mid month term - on prior to billing month
3) Mid month term - on later to billing month
4) End of month termination - with above 3 conditions
5) Add, term and cost change all on same month
Tested above scenarios with all billing policies - Bill for entire month, Premiums Waived Prior the Cut-Off Day,Premiums are Prorated
Note :- This ticket needs regression testing for retro term scenario with cost change
Jyoti Agrawal (Inactive)
added a comment - Below are 3C's :-
Concern :- Incorrect adjustment when there is cost change and election termination on mid of same month.
Cause :- Billing policies were not handled properly for mid month term and cost change on same month
Correction :- Handled above scenario
Affected Areas :-
All retro term adjustment
Affected File :- OES_SP_GetRetroBillingDetails_InvoiceBenefitWise
Tested Scenarios :-
Retro term and cost change on same month
1) Mid month term - on month equal to billing month
2) Mid month term - on prior to billing month
3) Mid month term - on later to billing month
4) End of month termination - with above 3 conditions
5) Add, term and cost change all on same month
Tested above scenarios with all billing policies - Bill for entire month, Premiums Waived Prior the Cut-Off Day,Premiums are Prorated
Note :- This ticket needs regression testing for retro term scenario with cost change As this is related to invoice, hence assigning to you.
Thanks,
Sachin Hingole
Jyoti Agrawal [~meghana joshi]
Sachin Hingole (Inactive)
added a comment - As this is related to invoice, hence assigning to you.
Thanks,
Sachin Hingole
Jyoti Agrawal [~meghana joshi] Hi Jyoti Agrawal,
Tested the retro term scenarios with cost change in same month with mid month terminations along with all the billing policies. All the scenarios worked as per expectation. Proper adjustments were displayed on Invoices.
This is ready for Stage
Thanks,
Venkatesh
Hi Jyoti Agrawal,
Testing is in progress for retro term scenarios with cost change in same month with mid month terminations. Will update this ticket once testing is completed.
Thanks,
Venkatesh
Hi Jyoti Agrawal,
Tested the retro term scenarios with cost change in same month with mid month terminations along with all the billing policies. All the scenarios worked as per expectation. Proper adjustments were displayed on Invoices.
This is ready for Production
Thanks,
Venkatesh
Hi Debbie Kulling,
Tested the retro term scenarios with cost change in same month with mid month terminations along with all the billing policies. All the scenarios worked as per expectation on Production Proper adjustments were displayed on Invoices.
Please could you verify and let us know if you have any queries on this.
Sachin Hingole,Prasanna Karlekar,Jyoti Agrawal
Thanks,
Venkatesh
Hi Debbie Kulling,
This issue is not related to correction. We tried to find the root cause but couldn't achieve today. We will be looking into this on Monday (7/3).
CC: Prasanna Karlekar
Regards,
Jyoti Agrawal