annual spouse attestation process – sshe health plan · pennsylvania’s state system of higher...

P E N N S Y L V A N I A ’ S S T A T E S Y S T E M O F H I G H E R E D U C A T I O NP E N N S Y L V A N I A ’ S S T A T E S Y S T E M O F H I G H E R E D U C A T I O N

Annual Spouse Attestation Process –SSHE Health Plan (Faculty, Nonrepresented, Coaches, SPFPA, and OPEIU)

9/21/17

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Agenda

1. Why are we implementing this process?

2. How does this process work?

3. What is the timeline for this process?

4. Role of the benefit coordinator

5. Questions?

6. Appendices

1


1. Why are we implementing thisprocess?

• The Value of Spouse Eligibility Criteria Employees hired prior to 7/1/2013 – 67% spousal coverage rate Employees hired on/after 7/1/2013 – 41% spousal coverage rate

May have had 328 more spouses enrolled @ $7,400 annualcost/spouse

Avoided $2.4 million in spouse-driven claims

2


2. How does this process work?• Automation was used as much as possible in developing this process.

• New transaction created in SAP that can be scheduled or manually executed by theSystem Benefits Office.

• Employees included in process are identified by: IT9006 Enrollment Type = ‘03’ meaning hired on or after 7/1/13 and

spouse/domestic partner enrolled in medical (No PEBTF)

IT9006 Date of Attestation is more than 305 days from the current system date

If IT9006 Date of Attestation = ‘blank’, then use IT9006 SP/DP Enrollment Date

IT9006 60 Day Annual Email = ‘blank’

Let’s look at these fields on the IT9006 screen on the next page.

3


2. How does this process work? (cont.)

4


2. How does this process work? (cont.)• When this process is executed, the employees identified will receive an

automated email alerting them of the spouse/domestic partner attestation.

• Employees will have 60 days to complete the attestation.

• Employees that do not complete the attestation will be issued a letter to notify them that their spouse / domestic partner will be removed from medical coverage.

• The 60 day email is listed on the next page.

5


2. How does this process work? (cont.)If an employee clicks the link, it will take them to login to Employee Self Service (ESS). Once logged in, the employee will be taken directly to the attestation process.

Since this may be a little hard to read, the 60 day email is listed as Appendix A later in this document.

6


2. How does this process work? (cont.)• Each benefit coordinator will receive a spreadsheet of employees that will

receive the 60 day attestation email.

7


2. How does this process work? (cont.)• 30 days later, the process will send an automated reminder email to employees

that received the 60 day email and have not completed the attestation by usingthe following criteria: IT9006 Enrollment type = ‘03’ meaning hired on or after 7/1/13 and

spouse/domestic partner enrolled in medical (No PEBTF)

IT9006 Date of Attestation is more than 305 days from the current systemdate

If IT9006 Date of Attestation = ‘blank’, then IT9006 SP/DP Enrollment Dateis used to confirm more than 305 days from current system date

IT9006 60 Day Email is more than 30 days from the current system date

Let’s look at these fields on the IT9006 screen again8


2. How does this process work? (cont.)

9


2. How does this process work? (cont.)If an employee clicks the link, it will take them to login to Employee Self Service (ESS). Once logged in, the employee will be taken directly to the attestation process.

Since this may be a little hard to read, the 30 day email is listed as Appendix B later in this document.

10


2. How does this process work? (cont.)• In lieu of viewing the attestation screens in ESS, please refer to Appendix C

(Spouse Attestation help document from ESS) which we will walkthrough next.

• Upon completion of the attestation process in ESS, an employee will be emailed the Spouse Attestation Employer Form if the following answers were provided: Spouse is employed; and Spouse is offered health care coverage for which he/she is eligible; and Spouse is not enrolled in employer’s coverage, OR

Spouse is employed; and Spouse is not offered health care coverage for which he/she is eligible;

• The email that the employee will be sent is listed on the next page.

11


2. How does this process work? (cont.)Since this is may be a little hard to read, the email is listed as Appendix D later in this document along with the revised Spouse Employer Form.

12


2. How does this process work? (cont.)• New audit created – Monday Benefit Audit Step 27 to allow benefit coordinators

to see employees that have less than 30 days remaining to complete theattestation.

• Refer to Appendix E to view the audit.

• For employees that do not complete the attestation process, the SystemBenefits Office will send a letter notifying the employee of the spouseterminating from medical coverage. The university benefit coordinator willreceive a copy of the letter.

• The letter can be viewed in Appendix F.

13


3. What is the timeline for this process?• This initial process will be completed in waves or phases.

14


4. Role of the benefit coordinator• Benefit coordinator will send an email to employees prior to the date that the

attestation transaction is executed by the System Benefits Office.

• System Benefits Office will provide the email content and email addresses of employees that should be sent the email. Employees may be likely to read the email since it is sent by their university benefit

coordinator.

By informing employees about the automated email coming soon, it should alleviate concerns of phishing or spam.

A copy of this email is listed on the next page.

15


4. Role of the benefit coordinator (cont.)• The email alerts the

employee: the day the email

will be sent;

sender of theemail;

email subject

16


4. Role of the benefit coordinator (cont.)• The benefit coordinator may choose to follow-up with employees that have not

taken any action with the attestation by monitoring Monday Benefit Audit Step27.

• In order for annual attestation process to be effective, benefit coordinators needto monitor:

Monday Benefit Audit Step 14 – Employees Hired on/after 7/1/13 All employees that completed the attestation process in ESS will now

be on this audit with the exception of employees that indicated theirspouse was unemployed.

The audit will indicate if the employee’s attestation needs to bereviewed / verified by the benefit coordinator, or

If the employee needs to provide an employer form for the spouse Sample of audit is listed later in document as Appendix G.

Refer to BN_3021_BPP Employee Spouse Domestic Partner Attestation.

17


4. Role of the benefit coordinator (cont.) Monday Benefit Audit Step 15 – Attestation Next Enrollment Date is Passed

For employees that provided the next enrollment date that theirspouse can get coverage under his/her employer, this audit alerts thebenefit coordinator that this date has now passed.

Employees need to be contacted to confirm that the spouse hasenrolled in their employer’s coverage / may request copy of spouse’sID card to confirm.

Sample of audit is listed later in document as Appendix H.

Refer to BN_3021_BPP Employee Spouse Domestic PartnerAttestation. BPP is listed later in document as Appendix I.

18


5. Questions?

19


6. AppendicesA. 60 Day EmailB. 30 Day EmailC. ESS Spouse/Domestic Partner Help DocumentD. Employee Email with Spouse/Domestic Partner Employer FormE. Monday Benefit Audit Step 27F. Employee Spouse Coverage Termination LetterG. Monday Benefit Audit Step 14H. Monday Benefit Audit Step 15I. BN_3021_BPP – Employee Spouse Domestic Partner Attestation

20

Appendix A – 60 Day Email

Sender: Do Not Reply ([email protected]) Subject: Annual Spouse/Domestic Partner Attestation Message:

For employees hired on or after July 1, 2013, health care coverage for your spouse/domestic partner in the State System of Higher Education Group Health Plan (SSHEGHP) requires your spouse/domestic partner to enroll in their own employer’s group health plan, if available, for their primary health care coverage.

Your spouse/domestic partner must enroll in their employer’s group health plan for primary health care coverage as a condition of SSHEGHP’s secondary health care coverage, without regard to:

• The cost to the spouse/domestic partner for their employer's coverage;• Any incentives the spouse/domestic partner may receive to decline their employer's coverage

According to your last spouse/domestic partner attestation on file with your university benefits department, it is time to recertify your spouse/domestic partner attestation for continued SSHEGHP medical insurance coverage.

You will need to know the following about your spouse’s/domestic partner’s employment situation and employer prior to completing the attestation:

• Employment status;• Employer information including name, address, and telephone number;• If the employer offers health care to which your spouse/domestic partner is eligible;• Health care enrollment status of your spouse/domestic partner under his/her own employer’s plan;• Health care insurance provider for your spouse’s/domestic partner’s coverage under his/her own employer’splan;• Health care ID/policy number for your spouse’s/domestic partner’s coverage under his/her employer’s plan;• Health care coverage effective date for your spouse/domestic partner under his/her own employer’s plan;

Please click the following link to recertify your spouse/domestic partner attestation via Employee Self-Service (ESS):

https://portal.passhe.edu/EmployeeAttestation.jsp

After logging into the portal, please find the Attestation on the right side of the screen. If you need assistance with this process, please refer to the Help Documents link on the top of the screen. The Spouse or Domestic Partner Attestation help document is located under the Personal Information heading.

You will have 60 days to complete the spouse/domestic partner attestation in ESS. Depending upon the answers provided for the attestation, you may be emailed the Spouse or Domestic Partner Employer Information Form. This form needs to be provided to your spouse/domestic partner’s employer to certify health care coverage information. The attestation and the Spouse or Domestic Partner Employer Information Form, if applicable, must be completed within 60 days, or your spouse/domestic partner may lose SSHEGHP health care coverage effective on the 61st day.

If you have any questions, please contact your university human resources department.

Return to Presentation

mailto:[email protected]


Appendix B – 30 Day Email

Sender: Do Not Reply ([email protected]) Subject: Annual Spouse/Domestic Partner Attestation Message:

For employees hired on or after July 1, 2013, health care coverage for your spouse/domestic partner in the State System of Higher Education Group Health Plan (SSHEGHP) requires your spouse/domestic partner to enroll in their own employer’s group health plan, if available, for their primary health care coverage.

Your spouse/domestic partner must enroll in their employer’s group health plan for primary health care coverage as a condition of SSHEGHP’s secondary health care coverage, without regard to:

• The cost to the spouse/domestic partner for their employer's coverage;• Any incentives the spouse/domestic partner may receive to decline their employer's coverage

According to your last spouse/domestic partner attestation on file with your university benefits department, it is time to recertify your spouse/domestic partner attestation for continued SSHEGHP medical insurance coverage.

You will need to know the following about your spouse’s/domestic partner’s employment situation and employer prior to completing the attestation:

• Employment status;• Employer information including name, address, and telephone number;• If the employer offers health care to which your spouse/domestic partner is eligible;• Health care enrollment status of your spouse/domestic partner under his/her own employer’s plan;• Health care insurance provider for your spouse’s/domestic partner’s coverage under his/her own employer’splan;• Health care ID/policy number for your spouse’s/domestic partner’s coverage under his/her employer’s plan;• Health care coverage effective date for your spouse/domestic partner under his/her own employer’s plan;

Please click the following link to recertify your spouse/domestic partner attestation via Employee Self-Service (ESS):


After logging into the portal, please find the Attestation on the right side of the screen. If you need assistance with this process, please refer to the Help Documents link on the top of the screen. The Spouse or Domestic Partner Attestation help document is located under the Personal Information heading.

You will have 30 days to complete the spouse/domestic partner attestation in ESS. Depending upon the answers provided for the attestation, you may be emailed the Spouse or Domestic Partner Employer Information Form. This form needs to be provided to your spouse/domestic partner’s employer to certify health care coverage information. The attestation and the Spouse or Domestic Partner Employer Information Form, if applicable, must be completed within 30 days, or your spouse/domestic partner may lose SSHEGHP health care coverage effective on the 31st day.

If you have any questions, please contact your university human resources department.




Appendix C - ESS Spouse/Domestic Partner Help Document Page 1 of 7

Pennsylvania State System of Higher Education – Updated September 2017

ESS – Personal Information – Family/Related Persons – Spouse/Domestic Partner Attestation

1. To complete the Spouse/Domestic Partner Health Care Enrollment Attestation, click on theAttestation button as shown to begin the process.

2. The following pop-up window will be displayed. Click on the “Provide Spouse/DomesticPartner Health Care Enrollment Attestation” button.


Employee Self-Service (ESS) Screens – Personal Information – Family/Related Persons – Spouse/Domestic Partner Attestation Page 2 of 7


3. The current spouse/domestic partner attestation on file for the employee record will bedisplayed.



4. If the attestation to be provided matches the current data in the system, choose the “Icertify my spouse/domestic partner health care enrollment attestation remains the same” asshown here and skip to step 5 below.

If the attestation to be provided does not match the current data in the system, skip to step 6 below.

5. The “Certification” information section will automatically appear to certify the informationprovided is true and correct. Click in the “I declare that I have read the above certificationand that all provided information is correct” box to agree.

Next, click the “Save my attestation data” button.



5.1. Upon completing Step 5, the employee may receive an email requesting the completion of the Spouse or Domestic Partner Employer Information Form depending upon the information provided during the attestation. Please refer to pages 6 and 7 for a sample of the Spouse or Domestic Partner Employer Information Form as well as additional information regarding the process.

6. If the attestation to be provided does not match the current data in the system, choose the“I need to update my spouse/domestic partner health care enrollment attestation”, whichwill initiate the process to collect new attestation information.

7. As the request for data appears on the screen, provide information by either makingselections from drop-down boxes:

Or, provide data by keying it into the system where applicable..



8. When all required data has been entered, the “Certification” information section willautomatically appear at the bottom of the screen to certify the information provided is trueand correct. Click in the “I declare that I have read the above certification and that allprovided information is correct” box to agree.

Next, click the “Save my attestation data” button.

8.1. Upon completing Step 8, the employee may receive an email requesting the completion of the Spouse or Domestic Partner Employer Information Form depending upon the information provided during the attestation. Please refer to pages 6 and 7 for a sample of the Spouse or Domestic Partner Employer Information Form.

Return to PresentationAppendix D – Employee Email with Spouse/Domestic Partner Employer Form

Sender: Do Not Reply ([email protected]) Subject: Spouse/Domestic Partner Employer Information Form Attachment: Spouse or Domestic Partner Employer Information Form.pdf Message:

Thank you for completing the Spouse/Domestic Partner Attestation process via Employee Self-Service. Based upon the information provided in your attestation, your spouse's/domestic partner's employer must complete the Spouse/Domestic Partner Employment Information section of the attached form. An original copy of the completed form must be provided to your university's benefits department by the original due date of the attestation.


www.passhe.edu 14 universities. Infinite opportunities.

Spouse/Domestic Partner – Employer Information Form

State System Employee Name: State System Employee Hire Date:

Spouse/Domestic Partner Name:

If an employee wishes to enroll his or her spouse or same-sex domestic partner in the PASSHE health plan, and that spouse or partner is eligible for coverage under their own employer’s plan, the spouse/partner shall be required to enroll in their own employer’s plan as a condition of eligibility for secondary coverage under the PASSHE health plan.

Please complete and submit the form to your university benefits office.

Spouse/Domestic Partner Employment Information (To be completed by the spouse/domestic partner’s employer)

Spouse’s/Domestic Partner’s Employer:

Employer Address:

Employer Phone Number:

Does your organization provide single healthcare coverage at no cost to the employee (i.e. fully employer paid)? Yes No

Is the spouse/partner named above employed in a health benefits eligible position with your organization? Yes No

Is the spouse/partner enrolled in that plan? Yes No

If the spouse/partner is not currently enrolled in your organization’s health plan, indicate if you would consider our condition of eligibility for secondary coverage a HIPAA special enrollment event that would allow your employee the opportunity to enroll in your organization’s health plan?

Yes No

If the question above is no, please list the date of your next open enrollment: _______________________________

Name of Employer Representative:

Signature of Employer Representative:

Employer Representative Email:

Employer Representative Phone:

Date:

Revised 9/2017

Appendix E – Monday Benefit Audit Step 27 Return to Presentation

Appendix F – Employee Spouse Coverage Termination Letter

2986 N. Second Street, Harrisburg, PA 17110-1201 | 717.720.4000 | www.passhe.edu 14 universities. Infinite opportunities.

Date

Employee Name Address City, State Zip

SUBJECT: Termination of Spouse / Domestic Partner Medical Coverage

Over the past sixty days, the Pennsylvania State System of Higher Education (State System) has sent two automated emails to your work email address indicating that you were required to complete an annual attestation for your spouse / domestic partner to remain enrolled in State System medical benefits.

As of the date of this letter, you have not completed your attestation for your spouse / domestic partner. Therefore, your spouse/domestic partner will be terminated from State System health benefits effective December 31, 2017.

Your spouse/domestic partner may be considered for reinstatement of coverage retroactive to sixty days once the annual attestation is completed and if required, the spouses’ / domestic partner’s employer has completed any necessary forms.

To avoid a gap in coverage, the attestation and any forms must be completed by February 28, 2018.

If you believe you already successfully completed the attestation process, please provide proof of completion to your university human resources department.

If you have any additional questions, please contact your university human resources department.

State System Benefits Office

OFFICE OF THE CHANCELLOR


Appendix G - Monday Benefit Audit Step 14AUD Benefits - Employees Hired on/after 7/1/2013 Attestation

This audit is for employees hired on or after 7/1/2013.

Refer Attestation Status column on this report for further

instructions of how to proceed w/ attestation verification.

Personnel area PRNR Date of Hire Pers Subarea EE Group

Ben Group Start Ben Group

Att Start Att Type

Employed Offer Care

Zero Cost

Enrolled Care

Next Enroll Date

Ins Prov Policy #ER Form Req

ER Form Rec

Verified By Verified Date

60 Day 30

DayDays Not Verified

Attestation Status IT9006 Comments

Bloomsburg University 146034 08/20/2016 APSCUF T

08/19/2017 TEMP

8/19/201703

30 No Attest\No Spouse Enrollment

Bloomsburg University 191990 08/19/2017 APSCUF P

08/19/2017 SSHE

8/19/201703

E Y Y

AetnaY Y

SEIGFREID 9/11/2017 30 Must Have Provider and Policy

Bloomsburg University 193244 08/19/2017 APSCUF P

08/19/2017 SSHE

8/19/201703

E Y N

1/1/2018 30 Request Employer Form

California University 184462 08/28/2017 Management P

08/28/2017 SSHE

8/28/201703

E N

21 Request Employer Form

California University 193808 08/19/2017 APSCUF T

08/19/2017 TEMP

8/19/201703

E Y N

9/1/2017Y

15DBALLA 8/30/2017 30 Waiting for Employer Form

Clarion University 17506 08/20/2016 APSCUF T

08/19/2017 TEMP

8/19/201703



08/19/2017 TEMP

8/19/201703


Clarion University 145249 07/10/2017 Coaches P

07/10/2017 SSHE

7/10/201703

E Y N Y Y Y

SWILLIAMS 7/28/2017 70 Must Have Provider and Policy


08/19/2017 TEMP

7/1/201703


East Stroudsburg University 77725 05/31/2014 APSCUF T

08/19/2017 TEMP

8/19/201703


East Stroudsburg University 151107 08/24/2013 APSCUF P

10/22/2016 SSHE

9/1/201703


Edinboro University 194126 08/19/2017 APSCUF T

08/19/2017 TEMP

8/19/201703

E N

LHARRISON 9/1/2017 30 Request Employer Form

Indiana University 89600 07/24/2017 APSCUF T

08/19/2017 TEMP

8/19/201703

E Y N N

11/1/2017 LVEHOVIC 9/14/2017 30 Request Employer Form


08/19/2017 TEMP

8/19/201703


Kutztown University 60160 08/22/2015 APSCUF T

07/01/2017 TEMP

9/1/201703

E N N Y

45JADAM 8/31/2017 17 Waiting for Employer Form

Kutztown University 192843 08/21/2017 Management P

08/21/2017 SSHE

8/21/201703

E N Y

45JADAM 28 Waiting for Employer Form

Lock Haven University 156361 01/11/2014 APSCUF P

08/19/2017 SSHE

9/2/201703


Lock Haven University 188545 12/21/2016 SPFPA Agr P

07/01/2017 SSHE

8/12/201703


Lock Haven University 191766 05/22/2017 APSCUF P

08/19/2017 SSHE

8/19/201703


Shippensburg University 195395 08/19/2017 APSCUF P

08/19/2017 SSHE

8/19/201703


Slippery Rock University 43250 08/22/2015 APSCUF T

08/19/2017 TEMP

8/19/201703



08/19/2017 TEMP

8/19/201703



08/19/2017 TEMP

8/19/201703


Slippery Rock University 191388 08/19/2017 APSCUF P

08/19/2017 SSHE

8/19/201703


Slippery Rock University 191885 07/03/2017 Management P

07/03/2017 SSHE

7/3/201703

U 77 Update Verification


08/19/2017 SSHE

8/19/201703


Slippery Rock University 192997 07/24/2017 Coaches P

07/24/2017 SSHE

7/24/201703

E Y N

1/12/2018 56 Request Employer Form


08/19/2017 SSHE

8/19/201703


Slippery Rock University 195282 09/05/2017 Coaches P

09/05/2017 SSHE

9/5/201703


West Chester University 166639 08/15/2016 OPEIU Agr P

08/28/2017 SSHE

8/28/201703


West Chester University 172959 08/22/2015 APSCUF P

10/22/2016 SSHE

8/1/201703


West Chester University 193148 07/31/2017 Management P

07/31/2017 SSHE

7/31/201703

E Y Y

Arkansas BCBSN

49 Must Have Provider and Policy

West Chester University 194311 08/19/2017 APSCUF P

08/19/2017 SSHE

8/19/201703

E Y Y

30 Must Have Provider and Policy will provide policy number new job so not avail

West Chester University 195739 09/11/2017 Management P

09/11/2017 SSHE

9/11/201703


For more guidance on the attestation process, refer to BPP:


Appendix H - Monday Benefit Audit Step 15AUD Benefits - Attestation Next Enrollment Date is Passed

The Next Enrollment Date on IT9006 has passed for the spouse

or domestic partner. However, the Insurance Provider and/or

ID/Policy Number fields remain incomplete.

Personnel area PRNR Date of Hire Pers SubareaEE Group

Ben Group Start Ben Group Att Start Att End Att Type EmployedOffer Care

Zero Cost

Enrolled Care

Next Enroll Date

Ins Prov Policy #ER Form Req

ER Form Rec

Verified By Verified DateDays Not Enrolled

Ins Info Incomplete

California University 193808 08/19/2017 APSCUF T

08/19/2017 TEMP 8/19/2017 12/31/9999 03 E Y N 09/01/2017

Y 15DBALLA 08/30/2017

17 Update Insurance Provider and Policy Info


06/12/2017 TEMP 6/12/2017 12/31/9999 03 E Y N 09/13/2017

Y Y

LVEHOVIC 07/10/2017 5

Update Insurance Provider and Policy Info

Follow up with employee to obtain insurance information and

update the IT9006 record with spouse or domestic partner

insurance information. (BN_3021_BPP Benefits - Employee

Spouse Domestic Partner Attestation)


BENEFITS BUSINESS PROCESS PROCEDURE (BPP) BN_3021_BPP Benefits – Employee Spouse/Domestic Partner Attestation

Pennsylvania State System of Higher Education

(PASSHE)

Last revised: BPP name: Page: 09/20/2017 BN_3021_BPP Benefits – Employee Spouse Domestic Partner

Attestation (created 08/5/2013) 1 of 18

Purpose/Scope:

PASSHE has implemented the Employee Attestation process, which requires any PASSHE employee in 1st Program Grouping of SSHE or TEMP to complete an attestation regarding the employment and related medical benefit coverage status for his or her spouse or domestic partner.

This BPP will cover both memos dated March 9, 2001 and July 1, 2013.

Note: The data in the current payroll system was converted on 12/10/2003. During conversion the original date a spouse or domestic partner was enrolled in coverage was not retained. Therefore, the date of 12/13/2003 (first day of the first pay period after the conversion) will be used in place of 7/1/2001 to identify new spouses or domestic partners added to coverage in respect to the memo above.

Dependent children will not be included in this process due to the new Health Care Reform laws.

Appendix I Return to Presentation


Attestation (created 08/5/2013)) 2 of 18

The purpose of this BPP is to illustrate the process of verifying and documenting the aforementioned employee attestation.



Requirements and/or Conditions:

1. Employee must be in 1st Program Grouping of either SSHE (State System) or TEMP (Temporary APSCUF). (Note: 1st Program Grouping assignment is identified on Infotype 0171, General Benefits Information, in SAP).

2. Employee must have a spouse or a domestic partner listed on Infotype 0021, Family/Related Person, and the spouse or domestic partner listed on Infotype 0021 must also be enrolled in the medical plan under Infotype 0167, Health Plans, in SAP.

3. Assignment of the spouse/domestic partner (SP/DP) enrollment type on Infotype 9006, Employee Attestation, in SAP is determined by the following rules.

a. Assignment of enrollment type ‘01’, No restrictions (SP/DP enrolled prior to 12/13/2003, or SP/DP not enrolled, or has no spouse or domestic partner record)

i. The spouse or domestic partner must be continuously enrolled in the employee’s SSHE or TEMP medical plan prior to 12/13/2003 through the present, or

ii. The spouse or domestic partner is not currently enrolled in the employee’s SSHE or TEMP medical plan or the employee has elected to waive medical coverage, or

iii. The SSHE or TEMP benefit eligible employee does not currently have a spouse or domestic partner record.

b. Assignment of enrollment type ‘02’, SP/DP enrolled on or after 12/13/2003 (in any continuous MEDI plan for SSHE - not to include PEBT)

i. The employee’s Current Hire Date is before 7/1/2013, and

ii. The spouse or domestic partner was enrolled in the employee’s SSHE or TEMP medical plan on or after 12/13/2003 and continues to be enrolled through the present date.

c. Assignment of enrollment type ‘03’, SP/DP enrolled, employee hired on or after 07/01/2013

i. The employee’s Current Hire Date is on or after 7/1/2013, and

ii. The spouse or domestic partner is enrolled in the employee’s SSHE or TEMP medical plan.

4. An Employee Attestation is only required when the spouse or domestic partner enrollment type indicator on Infotype 9006 is ‘02’ or ‘03’ as described above.



In order to assist in tracking the Spouse/DP Enrollment Type, a custom program has been created that will run every night capturing changes to the employee’s medical enrollment. This program is ZPR00048, Update IT9006 – Employee Attestation, and will automatically run and perform the following:

1. Create the initial IT9006 record for new hires, rehires, and employees transferring into a SSHE or TEMP benefit group.

2. Delimit the record on separations and employees that transfer out of a SSHE or TEMP benefit group.

3. Delimit the old record and create a new record for employees that have a change to their spouse’s/DP’s enrollment.

Note: Employee Attestation, IT9006, will be created with an effective date starting on

7/1/2013 going forward. The custom program will create the initial record for all employees. The current focus, at the time this BPP was written, is to verify the attestations for employees hired or rehired on or after 7/1/2013, or employees adding a spouse or domestic partner on or after 7/2/2013. All remaining attestations will be verified during an annual review that will be established.



Example scenario: Scenario 1: An employee has been employed with PASSHE since 01/11/2003. The employee’s spouse is enrolled in the employee’s medical plan since conversion, 12/10/2003. The program ZPR00048 that runs every night has assigned an enrollment type of ‘01’ accordingly. In this case, the employee’s record will not show on the audit as needing to be verified by the benefits coordinator since the Spouse/DP Enroll Type is “01”.



Scenario 2: An employee has been employed with PASSHE on 07/13/2013. The employee has enrolled into the waive plan. The program ZPR00048 that runs every night has assigned an enrollment type of ‘01’ accordingly. In this case, the employee’s record will not show on the audit as needing to be verified by the benefits coordinator since the Spouse/DP Enroll Type is “01”.



Scenario 3: An employee has been employed with PASSHE since 01/08/2005. The employee’s spouse is newly enrolled in the employee’s medical plan on 07/15/2013. The program ZPR00048 that runs every night has delimited the prior IT9006 record and added a new record effective 7/15/2013 with an enrollment type of ‘02’. In this case, the employee’s record will show on the audit as needing to be verified by the benefits coordinator since the Spouse/DP Enroll Type is “02” and Verified By and Verified Date fields are blank. For verification, the benefits coordinator must receive a signed, paper copy of the Spouse/Domestic Partner Health Care Enrollment Attestation (example provided on the proceeding page) from the employee. The Process Execution section below will explain how to properly update Infotype 9006 with employee attestation documentation.

Note: If an employee was hired prior to 07/01/2013 and enrolled their spouse or domestic

partner between 12/13/2003 and 07/01/2013, the employee will be listed as a type “02”, but they will not show up on the audit until an annual process has been established and completed. If you receive an attestation for these employees, please complete IT9006 screen as described below. It never hurts to be proactive.



Scenario 4: An employee was hired by PASSHE on 07/01/2013. The employee’s spouse is enrolled in the employee’s medical plan on 07/01/2013. The program ZPR00048 that runs every night has created a record effective 07/01/2013 with an enrollment type of ‘03’. In this case, the employee’s record will show on the audit as needing to be verified by the benefits coordinator since the Spouse/DP Enroll Type is “03” and Verified By and Verified Date fields are blank. In these cases, most likely, the employee has completed the form through the My First Days ESS process and the data has been populated. If the employee did not complete the attestation through ESS, then the benefits coordinator must receive a signed, paper copy of the Spouse/Domestic Partner Health Care Enrollment Attestation (example provided on the proceeding page) from the employee. The Process Execution section below will explain how to properly update Infotype 9006 with employee attestation documentation.



Below are the two forms that will be used to obtain the attestation information if not entered by the employee through ESS. There is one form for employees hired on/after 07/01/2013 and a separate form for employees hired prior to 07/01/2013.



Below is the Employer Information Form. This form may be needed depending on how the employee completes their attestation form.



Process Execution I. Updating/editing Infotype 9006 with an employee attestation 1.1. Upon receiving a completed, signed copy of the Spouse/Domestic Partner Health Care

Enrollment Attestation form from the employee, enter SAP transaction PA30.

2.1. Enter the employee Personnel No. and press Enter.



3.1. Navigate to the Benefits tab and highlight Employee Attestation (9006). Click Overview.

4.1. Select the appropriate record. (Note: This will normally be the most recent record. The start date will equal or be greater than the start date the employee added their spouse to covrage. If there is not a record with that start date, you will need to copy the exsisting record, change the start date, and continue with this process. DO NOT UPDATE A PRIOR RECORD.)

4.2. Select the chagne icon.



5.1. Using the data provided by the employee on the Spouse/Domestic Partner Health Care Enrollment Attestation form, complete the applicable fields on Infotype 9006 by entering the corresponding data into the appropriate fields in SAP. For example: The Date of Attestation will be the date the employee signed the attestation paper (not today’s date)

IMPORTANT – See next section for completing the “Verified By” and “Verified Date” fields for this screen. You do not verify the record unless everything is

complete and correct with the record. 6.1. Click Enter and then Save.

7.1. Attestation is now complete for the employee.



II. Completing “Verified By” and “Verified Date” fields on Infotype 9006 Upon review of the Spouse\DP Attestation Audit or receipt of an Employer Information Form, you will need to review and verify the employee’s attestation. Below is a sample of the audit query for attestations. The audit will help direct you with what is needed to complete the attestation.



8.1. You have received an Employer Information Form for PRNR 150689.

8.2. Use PA30

8.3. Select the Benefits Tab

8.4. Highlight the Employee Attestation row

8.5. Select the Overview icon.

9.1. Highlight the appropriate row to update.

9.2. Select the Change icon.



10.1. Complete the screen with the data received on the Employer Information Form. In this example, the Employer Information Form confirmed the next enrollment date for the spouse was 1/1/2014.

10.2. Update the Employer Form Requested field.

10.3. Update the Employer Form Received field.

10.4. Add comments as needed in the Comments field. (Note: You can add additional text by going to the SAP toolbar, selecting Edit, and then Maintain Text.)

10.5. Update the Verified By field with your user ID (Note: You should never update your own record. Please have someone else in your department or the Central Office update your record.)

10.6. Update the Verified Date field with today’s date.

Note: Completing the Verified By and Verified Date means you have reviewed all relevant information and received and reviewed all required documents that prove the employee is in compliance with adding their spouse or domestic partner to coverage. You will never complete these fields if you cannot make that statement. See next section when the employee does not complete or return the required documents.



III. Required Documents Not Returned When an employee is over the 60 day threshold for returning their documentation, the following steps will occur. 11.1. The Central Office will contact the university to discuss the situation. During this discussion, they

will establish:

11.2. Has the employee been properly notified?

11.3. Has everything been documented?

11.4. Are there any outstanding circumstances?

11.5. Plan for ending the spouse’s/domestic partner’s benefits.

12.1. Once the established plan has expired and the employee still has not supplied the required documents, the Central Office will end the spouse’s/domestic partner’s benefits.

12.2. Enter PA40 Benefits-Health Plan reason Change Plan (CENTRAL ONLY) and remove the spouse/domestic partner from the health care.

12.3. Copy any documentation that may be on the IT9006 record, Employee Attestation to the IT0167, Heath Plan.

12.4. Add further text to the IT0167, Health Plan, to fully document the steps that were taken before removing the spouse/domestic partner from the employee health care.



Notes/Further Reference The audit is only as good as the data that is keyed into the system. Therefore, there is some expectation that the benefit coordinator will review the attestation form and if it is incomplete will request the employee to update the form with the missing data prior to entering the data into the system. Example: If the employee lists that their spouse or domestic partner is employed, we would assume the spouse’s/domestic partner’s employer name and address will be completed. If they are not, this would be an incomplete form and should be returned to the employee to complete. If the employee uses the ESS application, My First Days, these screens will ensure the data is correctly gathered before the employee is allowed to continue. With that said, here is the logic that is used in the audits and the review you should be performing on the data before you verify the attestation:

Record Type Fields Value in

Field Action Verification

01 No verification needed

02 & 03 Spouse/DP Employed Blank Request Attestation

Once the attestation is received, the employee should fall into one of the scenarios below

02 & 03 Spouse/DP Employed U Can complete the verification immediately

02 & 03 Spouse/DP Employed E

Can complete the verification immediately Insurance Provider Completed

ID/Policy Number Completed

02 Spouse/DP Employed E

Request and receive Employer Info Form

Can complete the verification after the employer form is received

No Cost Coverage Y Next Enrollment Date Completed

02 Any other scenario not listed above Can complete the verification immediately

03 Any other scenario not listed above Request and receive Employer Info Form

Can complete the verification after the employer form is received