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BENEFITFOCUS SYSTEM ENHANCEMENTS
Tasks Being Generated Due to Missing PCP
Please be advised that the Primary Care Provider (PCP) Selection feature was deployed this week. HBRs may have noticed PCP tasks under "Employees Require More Data" that indicate that employees are "Missing PCP Information". These tasks were generated by employees who accessed the tool to make another change but did not select a PCP. The configuration has now been updated and these tasks will no longer generate.
Benefitfocus is running task recalculations to remove these tasks from your queues
The State Health Plan would like to remind you of the new enhanced features within the eEnroll tool, formerly known as eBenefitsNow. These enhancements were reviewed during Annual Enrollment training and will help you more efficiently manage enrollment and communicate with your employees.
Decline button for To Do List tasks
The HBR will have the option to Decline the change made by a member and return the election to its previous state.
Example:
- An employee adds a spouse due to marriage, but does not provide the acceptable eligibility documentation within 30 days of the event
- The HBR selects the Decline button for the employee's Task List, and is taken to the final step in the benefit election workflow for the employee.
- The HBR selects Save.
- The History of Changes report will reflect the task that was declined.
Employee validation across agencies
If the employee attempts to enroll in the State Health Plan, but is still covered in another employing unit, that person will be prevented from enrolling in the Plan under the new group until the coverage is canceled from the previous group. Employees in that situation will receive a message notifying them that they cannot enroll because they are covered by another group, as shown below:
If the employee's coverage has a future cancellation pending, the validation logic will compare the cancellation date of the existing coverage to the effective date of coverage for the new enrollment before determining if the new coverage can be added.
Example: On May 8, 2013, the employee logs into the enrollment system. If coverage is showing canceled under Gaston County on July 30, 2013, and the requested effective date to enroll under the Retirement System is August 1, 2013, the employee will be able to enroll.
It is extremely important for Benefitfocus HBRs to process terminations timely and correctly.
For members who are retiring, the HBR must cancel coverage once they receive the official notification of a member's retirement to ensure they are able to enroll in the health plan under the Retirement System. Active agencies carry the member through the end of the month in which the retirement occurred (i.e. Date of Retirement: July 1 = benefits end July 30). The Retirement System is set up to calculate a benefit effective date of the first of the month following the Date of Retirement date (i.e. Date of Retirement: July 1 = benefits start August 1). Life event during OE change
The HBR or member will have the option of selecting a change reason or Open Enrollment for the reason for the change.
The HBR/member would enter their life event information as below:
When the life event is entered in the OE tab, the HBR or member will receive a message that the event may be applicable to the current benefits. They can then click the provided link to access the Current Benefits and take that appropriate action.
Future termination event change
An HBR can enter a future termination or event that is greater than 30 days and this change will be held for processing until 30 days prior to the effective date. This allows for additional changes to be entered if necessary.
Example: A future retirement is entered today with a 6/30/13 benefit end date. This change is then saved.
The HBR then sees an "Activity" tab with all future activities for that member.
The Activity tab displays future actions and allows this to be Edited or Removed.
SHP Medicare Primacy
Benefitfocus has made enhancements to the Medicare primacy functionality:
- Easily identifies people who are 90 days away from turning 65 and who do not have Medicare information entered in eEnrollment (HR role).
- When a person turns 65, Medicare Part A (and Part B if retired) will be automatically populated in eEnroll if Medicare information has not been entered.
- The Medicare Payer Status will automatically calculate and update when Medicare is added for the first time, updated or when the person is termed or rehired.
Example: When the member is terminated due to retirement and is 65+ the HBR will have the message to "Save and go to Medicare."
The HBR is then taken to the Medicare Manager page and they can confirm all Medicare information and click Update. This will then give the member the reduced tier for their last month of coverage.
Additional Enhancements:
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FEATURE |
NOTES
| | Additional race options | The list of values available to
select from is changing to:
White, Black/African American,
Hispanic/Latino, Asian,
American Indian/Alaskan Native, Native Hawaiian or Other Pacific
Islander, Two or More Races | E-mail Notifications to HBRs
to notify them of pending
enrollments
| This feature will add the ability to send e-mail notifications to the
HBR for tasks that prevent the
transmission of an employee's
benefit enrollment information. | Universal Login Page
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Employees will be able to enter
their login credentials and be
directed to his/her correct
employing unit's HR InTouch
site.
Employees can begin using this
feature during Annual Enrollment | Retirement Termination
Reason
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HBRs can now enter a
retirement as a termination,
eliminating an extra step for
users.
If the member is retiring then
you can now complete this
within the termination process
by using the Termination due to
Retirement process.
The retirement process is
currently a two-step process;
cancel benefits with Change
Reason of Retirement and then
terminate the employee.
The system has been updated
to have two new termination
reasons; Retirement
(Not COBRA eligible) and
Retirement (COBRA eligible).
You can now click on the
Terminate Employment link
under Update Employee.
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Primary Care Provider
Selection |
The Plan encourages members
to have a Primary Care Provider (PCP).
Having a PCP supports the
concept of a Patient Centered
Medical Home (PCMH) - an
ongoing, active partnership with
your PCP who provides
proactive, preventive and
chronic care management
throughout all stages of your life.
To recognize the importance of
having a PCP, you will be able to select a PCP for yourself and
any covered dependents during
enrollment. The selection you
make will appear on your
member ID cards. |
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