State of Connecticut Core-CT Project

Application: HRMS Module: Benefits Business Process: Administer COBRA Requirement Number: BN204 Requirement Title: Ability to waive enrollment for COBRA elections automatically

Module Leads: Nancy McMahon, John Woodyard

1. Requirement Description Describe the requirement (gap). Include a description of the delivered PeopleSoft functionality. The State uses a third party administrator (TPA) to handle administration (elections and payments) of COBRA coverage and does not need to use the full functionality of the COBRA module. The State is only responsible for identifying and notifying those eligible for COBRA coverage.

Since the State is not enrolling participants, we need a way to close the eligibility for COBRA processing. If we were using the full COBRA functionality, the Agency Benefits Specialist would enter a waive or election for each participant, as responses were received. Since the responses are sent to the TPA, that process never occurs and everyone eligible for COBRA is left in an ‘open’/able to elect state. This will cause problems during open enrollment because the employees would incorrectly receive an Open Enrollment letter. This ‘open’/able to elect state would also cause problems if there were ever a mass event of which they would have been a part such as an across- the-board increase, department or location change. If the employee were not closed for processing the system would treat them as an active employee and insert new rows into their record. This would eventually cause the system to have millions of rows of useless data which could slow system performance and require extra storage space.

2. Business Need Provide a justification for the requirement. Include information about frequency, volume, number of users impacted, etc. The State needs to identify and notify the individuals eligible for COBRA coverage. Since the State uses a TPA, we do not want to use the enrollment portion of the module and need a way to automatically ‘waive’ coverage in PeopleSoft for all participants (the real enrollment data will be stored by the TPA)

3. Required By: (Y/N) Federal ____ Agency ____ Bargaining Unit ____

State Statutory ____ State Regulatory ____ State Procedural __Y__

4. Requirement Priority Medium (High, Medium, Low – please see “Requirements Prioritization Criteria”)

5. Recommended Solution Enter an “X” next to the appropriate category

______Process Solution ___ Option Number

___X___ Application Modification

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_1__ Option Number 6. Explanation for Recommendation Provide reasons for recommendation. Please do not re-state the description of the solution itself.

By automating this process, the State is ensuring that it occurs in a pre-determined time frame. Also, the COBRA administration is performed by a TPA, thus no additional work should be required of the Agency Benefits Specialist to handle COBRA, since they are not responsible for administration. In the as-is process the Agency Benefits Specialist is not required to perform any actions for COBRA after sending out the Initial Notification Letters and this recommendation is the only option which will not add new duties to the Agency Benefits Specialist’s role. Some Agencies could have as many as 200 terminations within a single month. To manually close these events would require a significant effort. Monitoring and enforcing Agency compliance with closing this open event by the use of reports, would require additional Comptrollers staff.

7. Organizational Impact of Recommendation Describe the changes to the organization that result from the recommended solution. Include a description of any role, process, statute, or bargaining unit agreement affected.

This program would be run in the batch schedule and would not require any work by the Agency Benefits Specialist.

8. Process Solutions Describe the possible Process Solutions. Include a description of impacts and benefits of each solution.

Option 1. After printing the COBRA notification letter, the Agency Benefits Specialist would manually waive COBRA coverage for each of those individuals. If this step is missed, the former employee/dependents would incorrectly receive open enrollment materials during the next open enrollment period. Any mass event could change the benefits status to active and additional rows would be added to the employee’s record.

9. Application Modifications Describe the possible Application Modifications. Include a description of impacts and benefits of each solution.

Option 1. Modification Type: Batch Complexity: Easy Description: Create a SQR program that would run in the batch schedule once per month to enter waive elections for all open COBRA participants. This job should also be timed to run right before the start of open enrollment processing. Option 2. Modification Type: Report Complexity: Easy Description: Create a report, to be used by each agency, to identify all individuals eligible for COBRA. The Agency Benefits Specialist would manually enter an election of ‘waive’ for each person identified on the report. This option has more potential for error then the batch process and would require the Agency Benefits Specialist to remember to run a new report that they currently do not use. For agencies that have large turnover this would also be a very timely process for the Agency Benefits

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Specialist each month because they would have to manually open each employee/dependent record and waive coverage.

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