ACA Employee Transmittal Data Is Incorrect When Employees Have Mid Year Events. Can We Customize The Delivered SQL To Ignore These Events? (Doc ID 2353263.1)

Last updated on NOVEMBER 25, 2022

Applies to:

Goal

The ACA Data Extract definition’s SQL to determine assignment Employee Offer of Coverage per Ben Admin Event has been evolving as different scenarios are provided. It seems there is no 1 SQL conditions that would satisfy all use cases as different events are setup differently that may or may not meet delivered SQL condition. In other words, there are exceptions.

Example, SQL condition is set to have Participant Plan’s Election Allowed to Yes(BAS_PARTIC_PLAN ELECT_ALLOWED = Y), otherwise Option will not open up for election; consequently it’s not considered as ‘Offer of Coverage’. However there are certain events (e.g. MSC, FSC) where BAS_PARTIC_PLAN ELECT_ALLOWED = N and it doesn’t open up for election (e.g. Medical) since it doesn’t need to due to defaulting or only certain Plan Types are eligible for election. In this case Medical should still be recognized as Offer of Coverage and it’s not based on delivered SQL in extract.

Solution

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