HIPAA OVERAGE DEPENDENT TERMINATION SHOWING INCORRECTLY ON FULL FILE AUDIT BEFORE AND AFTER OVERAGE EVENT DT

(Doc ID 2163301.1)

Last updated on DECEMBER 26, 2016

Applies to:

PeopleSoft Enterprise HCM Human Resources - Version 9.1 to 9.2 [Release 9]
Information in this document applies to any platform.

Symptoms

When Full File Audit is run on dates before/after the date of a dependent's overage event (overage event date = Mar 23/16, date coverage lost = Apr 1/16), two issues are occurring for an employee with family coverage including an overage dependent:

1. The output in the Mar 31/16 file is incorrect as only the terminated dependent is showing, with a DTP*348 enrolled record with incorrect dates.
At that point, all of the family, ee, sp, 2 children, should have been showing in the FFA.

2. Ran the file again at Apr 1/16
The file showed enrollment info correctly with ee, sp and 1 child, consistent with the FSC event rule's requirement.
The terminated dependent info was INCORRECT compared to what the FSC event rule required.


STEPS
-----------------------

1. Noted an employee who has a current Plan Type 10 Election with the following dates:
FSC event date due to overage dependent - Mar 23/16
Coverage Begin date - Apr 1/16 - emplID KU0120
elected family coverage, spouse + 1 child
deduction begin date Mar 28/16
2. Run Benefit Snapshot with "As of Date" of Mar 31/16.
Navigation: Benefits > Interface with Providers > Refresh Benefit Snapshot
3. Create HIPAA files with File Type of "Full File Audit".
Navigation: Benefits > Interface with Providers > Create HIPAA EDI 834 File
4. The output in the Mar 31/16 file is incorrect as only the overage dependent is showing, with a DTP*348 record.
At that point, all of the family, ee, sp, 2 children, should have been showing in the FFA.
5. Ran a new Ben100a/HIPAA 5010 process at Apr 1/16
The file showed enrollment info correctly with ee, sp and 1 child, compared to the FSC event rule's requirement.
The terminated dependent info was INCORRECT compared to what the FSC event rule required.


Cause

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