BN - Entering and Updating Benefits Personal Data

GENERAL DESCRIPTION:

This procedure will cover how to correctly enter benefit personal data, which drives the ETF Health Interface for State Group Health. Benefits Personal Data is where information regarding Medicare, Other Health Insurance, marital status, and ETF Member ID are stored. All of this information should be regularly updated from the ET-2301 Health Insurance Application Form completed by the employee.

PROCESS CONSIDERATIONS:

  • ETF requires these fields for accurate coordination of benefits. Critical fields include: Medicare, Spouse state employment, marital status, and other insurance information.  Incorrect information will not only be reflected in HRS, but will be transmitted to ETF and the insurance vendors and may cause claim issues and/or delays in payment.  Campus Benefit Administrators will need to do additional follow-up with an employee if information is not provided on the enrollment form.
  • Employees may be enrolled in plans that they actually are not eligible for due to missing other health insurance or medicare information
  • This screen must be updated whenever a new Health Insurance Application form is submitted by an employee.
  • If you do not have security access to update this page in HRS, you will need to work with your HR Department to update specific fields to ensure accurate and timely information is submitted to ETF.


PROCEDURE STEPS for ENTERING:

1. Navigate to:  Benefits > Employee/Dependent Information > Benefits Personal Data

2. Enter the Employee's ID and click the Search button.

3. The employee's ETF Member ID is listed here. This ID is ETF's 8 digit unique identifier for the employee in their database.

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COORDINATION OF BENEFITS:

a. If applicable, mark if the spouse is also a state employee.

b. Please select 'Yes' or 'No' to Other Health Insurance.

  • If 'Yes', then list all known information regarding the other insurance using the three fields: Insurance Company Name, Insurance Policy Number, Insurance Group Number

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This information can be found under the "Complete if you Have Additional Health/Coverage" information section 12, page 4 of the Health Insurance Application ET-2301 form as shown below:

HealthInsurance

MARITAL STATUS:

a. If applicable, provide Effective Date and Marital Status. 

Updating the Marital Status here will also automatically update the Marital Status found on the "Modify a Person" HRS page. 

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You can obtain the Marital Status information from "Applicant Information" section 1, page 1 of the Health Insurance Application ET-2301 form as shown below.

Marital Status

BENEFITS PERSONAL DATA

a. This box can be ignored

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BENEFITS PERSONAL DATA - DATE SENSITIVE

The Centers for Medicare Services (CMS) will be generating new Medicare Beneficiary Identifiers (MBI) for ALL Beneficiaries to replace Medicare A and B numbers.  This includes all currently active, deceased, archived, and new recipients.  CMS will begin issuing new, redesigned Medicare cards containing the NEW MBI numbers beginning April 1, 2018. 

  • If the employee is submitting a new Medicare Beneficiary ID (MBI) number, enter the information in HRS in the Alternate Medicare Number field.  Please open a ticket to the UW Service Center and your Affinity Group will take care of notifying ETF.

You can obtain the Medicare information from the "Complete if you are Covered by Medicare, section 11, page 3 of the Health Insurance Application ET-2301 form as shown below.

Medicare App

4.  Click the Save button


PROCEDURE STEPS for UPDATING:

1. Navigate to:  Benefits > Employee/Dependent Information > Benefits Personal Data

2. Click the Correct History button

3. Enter the Employee's ID and click the Search button.

4. The employee's ETF Member ID is listed here. This ID is ETF's 8 digit unique identifier for the employee in their database.

k

COORDINATION OF BENEFITS

a. If applicable, mark if the spouse is also a state employee.

b. Please select 'Yes' or 'No' to Other Health Insurance.

  • If 'Yes', then list all known information regarding the other insurance using the three fields: Insurance Company Name, Insurance Policy Number, Insurance Group Number
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MARITAL STATUS
a.  Add a row. Change As of to new marital date. Change the drop down to new marital status (i.e. divorced, widowed, etc.).
Marital Status Add a Row
b.  Note the new "As of" date cannot be older than the current "As of" date.

Updating the Marital Status here will also automatically update the Marital Status found on the "Modify a Person" HRS page. 
Marital Status Change

BENEFITS PERSONAL DATA

a. This box can be ignored

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BENEFITS PERSONAL DATA - DATE SENSITIVE
a.  Add a row to add new Medicare information or to remove Medicare information. Leave the HIPAA Medicare Elig Reason fields blank.

If the employee is submitting a new Medicare Beneficiary ID (MBI) number, enter the information in HRS in the Alternate Medicare Number field.  Please open a ticket to the UW Service Center and your Affinity Group will take care of notifying ETF.

b.  Change Effective Date to correspond to date that Medicare ends or new Medicare begins.

c.  Remove Medicare Numbers and reasons if the employee is no longer covered by Medicare.


5. Click the Save button

ADDITIONAL RESOURCES:

Related KBs:

Related Links:




Keywords:coordination of benefits, marital status, other insurance, medicare, ETF Member ID, Interface, state group health, add coverage, add dependent, remove dependent, health, marriage, divorce, single, widow, widowed, effective date   Doc ID:17882
Owner:Samantha Q.Group:Human Resource System (HRS)
Created:2011-04-06 18:00 CSTUpdated:2018-10-22 07:12 CST
Sites:Human Resource System (HRS)
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