Submitted on: August 20, 2009 Modified on: August 21, 2009 Modified on: October 7, 2009

SR82712

Move Open Enrollment carrier file process to MVS

Objective: This service request addresses requirements to move the entire Open Enrollment carrier file process to MVS.

Project Type: This is a change to the job that creates OE files for all insurance vendors.

Requested by: Christy Thompson, ISS

Analyst: Joi Adams, ISS

Due Date(s): The close of Open Enrollment – November 24, 2009.

SR82712 – Move Open Enrollment carrier file processes to MVS Page 1 1.0 PIP

1.1 Background Currently MVS delivers the Employee Open Enrollment files to Unix where a PIP job splits, encrypts and delivers the individual carrier files to MMI, Garnett-Powers, and UBH. UBH currently receives only a subset of the carrier files – B1, CG, H1, KN, KS and WH. The MVS process will be modified to render the final step of the current PIP process obsolete. The current process will be modified to deliver files to Avidity HCS, and not MMI.

1.2 New process for Open Enrollment files

Modify the MVS process to split the merged Open Enrollment files and deliver them directly to the VSFTP server. Encryption is no longer needed as the FTP server is secured.

The individual carrier files indicated below will then be placed on the VSFTP server for Avidity HCS, UBH and Garnett-Powers pickup.

D1 Delta Dental PPO D3 DeltaCare USA VI Vision Services Plan J2 ARAG Legal B1 Blue Cross H1 Health Net KN Kaiser North KS Kaiser South KU Kaiser Umbrella KW Kaiser Mid-Atlantic WH Western Health Advantage P1 PSBP Med HMO P2 PSBP Med PPO P3 PSBP Dental HMO P4 PSBP Dental PPO P5 PSBP Vision CG CIGNA

Avidity D1 Delta Dental PPO D3 DeltaCare USA VI Vision Services Plan J2 ARAG Legal CG Cigna B1 Blue Cross H1 Health Net KN Kaiser North KS Kaiser South KU Kaiser Umbrella KW Kaiser Mid-Atlantic WH Western Health Advantage

SR82712 – Move Open Enrollment carrier file processes to MVS Page 2 P1 PSBP Med HMO P2 PSBP Med PPO P3 PSBP Dental HMO P4 PSBP Dental PPO P5 PSBP Vision

UBH CG Cigna B1 Blue Cross H1 Health Net KN Kaiser North KS Kaiser South WH Western Health Advantage

Garnett-Powers P1 PSBP Med HMO P2 PSBP Med PPO P3 PSBP Dental HMO P4 PSBP Dental PPO P5 PSBP Vision

The vendor directories will be determined during design.

2.0 Email notification

2.1 HIPAA Translation – Avidity Currently there is no notification when the OE files are ready for pick up. Notification should now be sent to Avidity for the Open Enrollment files when ready.

The notification should be sent to [email protected] and a carbon copy to be sent to [email protected], [email protected], [email protected].

The text of the email notification for the Open Enrollment files to read:

Subject: Avidity Open Enrollment Carrier Files

Open Enrollment carrier files have been created and delivered to the Avidity dropbox for production of EDI Carrier Files.

Below this statement, all of the files that have been delivered should be listed in alpha order (See Attachment A)

2.2 UBH Send notification regarding the availability of Open Enrollment files to UBH.

SR82712 – Move Open Enrollment carrier file processes to MVS Page 3 The notification should be sent to [email protected] and a carbon copy to be sent to [email protected] and [email protected]

The text of the email notification should read:

Subject: UBH Open Enrollment Carrier Files

Open Enrollment carrier files have been created and delivered to the UBH dropbox.

2.3 Garnett-Powers Send notification regarding the availability of Open Enrollment files to Garnett-Powers after the monthly process.

The notification should be sent to [email protected] and a carbon copy to be sent to [email protected] and [email protected]

The text of the email notification should read:

Subject: Garnett-Powers Open Enrollment Carrier Files

Open Enrollment carrier files have been created and delivered to the Garnett-Powers dropbox.

SR82712 – Move Open Enrollment carrier file processes to MVS Page 4 Attachment A – Weekly UC Carrier File email notification

SR82712 – Move Open Enrollment carrier file processes to MVS Page 5