BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the...

54
BEN002 Benefits Enrollment (including Qualifying Events)

Transcript of BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the...

Page 1: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BEN002 Benefits Enrollment

(including Qualifying Events)

Page 2: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN002 Benefits Enrollment

Business Process Description To allow Full-Time new hire employees to enroll in benefits within 45 days of hire. Also includes the process to allow employees to change, cancel, and enroll based on life events and eligibility changes. ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. After the employee makes an election on ChoiceLinx, ChoiceLinx sends the benefits department an electronic file to upload in APECS.

Business Process Steps Step # Step Description Executed By 1. New Hires, Rehires, and Status change enrollment windows are

prompted by a file sent from APECS to ChoiceLinx. APECS system

2. Employees enroll, change, or cancel benefits In ChoiceLinx either through a prompted window or by prompting an event for themselves for life changes such as marriage, divorce, and birth.

Employee

3. Benefits Associates approve changes that require documentation or review and all changes are processed in ChoiceLinx.

Benefits Associate

Business Process Details As-Is Inputs: Employee Eligible File

As-Is Outputs: Elected Coverage send to Carriers

As-Is Systems: APECS Payroll system, ChoiceLinx, Vendor Systems

As-Is Controls: None

As-Is Interfaces: None

As-Is Reports: None

As-Is Statutes: None

Page 3: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

2

Business Process Map

Page 4: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN002 Benefits Enrollment

Executive Summary Benefits Enrollment is the process of enrolling employees into their benefits elections from their elections at the New Hire Orientation, or changing their benefits after a qualifying event. SCSD uses a third party provider, ChoiceLinx, for this task. From a process standpoint, the way APECSs and Choicelinx are set up is optimal. The process could use some review with regard to actions that trigger qualifying events, and benefits termination/reinstatement.

Process Issues

1. There is a great deal of movement in status in certain employee groups that should normally trigger coverage changes and do not. This results often in missed coverage for employees that should rightfully be covered.

2. The current benefits enrollment system does not have a reinstate coverage option which would be really useful.

Business Process Recommendations

• Eligibility rules should and will be revisited in a new ERP system. Actions/reasons that relate to RIF, Reiinstate should be considered when triggering COBRA after the RIF, and as a qualifying event up reinstatement.

Page 5: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BEN003 Benefits Billing

Page 6: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN003 Benefit Billing

Business Process Description The sole purpose is to ensure that employees with coverage are paying the district who is receiving the employee’s portion of the insurance premiums while on leave without pay for their medical coverage.

Business Process Steps Step # Step Description Executed By 1. At the end of the month, Leave Administrators request unpaid

request from HRIS Specialist. Leave Administrators

2. After receiving the report, Leave Administrators check APECS to ensure accuracy of missed premium payments.

Leave Administrators

3. Leave Administrators mail letters to employees allowing them 15 days to submit payments and avoid cancellation.

Leave Administrators

4. If payments are not received, the leave administrators will cancel the coverage utilizing the online benefits system (ChoiceLinx).

Leave Administrators

Business Process Details As-Is Inputs: No external inputs identified.

As-Is Outputs: No external outputs identified.

As-Is Systems: APECS, ChoiceLinx

As-Is Controls: None

As-Is Interfaces: None

As-Is Reports: Unpaid Leave of absence Report

As-Is Statutes: None

Page 7: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

2

Business Process Map

Page 8: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN003 Benefit Billing

Executive Summary Benefits Billing LOA is the process for billing insurance premiums for employees on leaves of absence. This ensures that employees who are out of work and not receiving a paycheck get billed for insurance premiums either at an employee rate or full cost. This allows the district to recover the allocated employee cost of insurance.

Process Issues

1. The system in place for billing is manual in nature. This makes it difficult to keep track of the balance of payments for each individual, potentially resulting in underpayments.

2. The process also relies upon a report run by the HRIS Specialist. Despite the best efforts of the HRIS Specialist, the back and forth of a request and response with a report adds an unnecessary lag into the process.

Business Process Recommendations

• Since Finance and HRMS will be on the same system, we will develop workflow between Benefits and Accounts Receivable to facilitate the collection of funds from the employee. When developing this process, it is important that the employee, AR, Benefits and Payroll are all part of the workflow notification process.

• Many systems allow an integration from Benefits to Accounts Receivable. This is ideal and replaces the report/query from the HRIS Specialist.

• Benefits will create a workflow reminder or a query that encapsulates all of the criteria to identify billing. If the functionality allows, we can set up eligibility criteria in Benefits that creates automatic enrollment in General Billing.

• Move to all electronic statements. The printing and mailing of statements from Accounts Receivable can be brought online where the person billed can check balances, amounts due, payment options, etc.

Page 9: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BEN004 Benefits Reporting

Page 10: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN004 Benefits Reporting

Business Process Description Employee benefits are a part of an employee’s total compensation and properly reporting benefits adds value to the customer experience by ensuring that benefits are available for use. Properly terminating benefits when eligibility ends helps the district to manage healthcare financial costs.

Business Process Steps Step # Step Description Executed By 1. Employees access their benefits information and review it via a self-

service web application. APECS

2. A snap shot of eligibility data is captured and sent to Carriers, this picks up terminations, new hires, rehires, status changes, and qualifying events.

ChoiceLinx

3. Vendor System receives eligibility information and it is loaded to their system.

Vendor Systems

4. Errors are logged. Vendor Systems 5. Errors are reviewed and corrected. Vendor Staff,

Benefits Associates, ChoiceLinx Employees

Business Process Details As-Is Inputs: Enrollment data, Eligibility data, Error file

As-Is Outputs: Corrected Error file

As-Is Systems: ChoiceLinx, Vendor Systems, APECS

As-Is Controls: None

As-Is Interfaces: None

As-Is Reports: None

As-Is Statutes: None

Page 11: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

2

Business Process Map

Page 12: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN004 Benefits Reporting

Executive Summary Benefit reporting serves the primary purpose of being a check and balance against automatic eligibility and enrollment. It is an audit for the Benefit department to proactively catch errors that could result in incorrect benefits coverage, or employees who deserve coverage and are not currently eligible.

Process Issues

1. Reports in APECS are custom written. Therefore, most any benefits report whose data resides in APECS rather than ChoiceLinx can be written and accessed.

2. The primary complaint voiced during our interviews is the lack of a central location accessible to the end user. This requires a request to HRIS or IT rather than simple access.

Business Process Recommendations

• In the new ERP, access to reports should be native to the system, and accessible via save links, dashboards, or through the end-user interface. Access should be based upon security role.

• Employees with access to Benefits information should have received HIPAA certified training. The role allowing access to benefits information should only be granted when this training is completed.

Page 13: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BEN005 Benefits Termination

Page 14: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN005 Benefits Termination

Business Process Description This process relates to benefits processing triggered by employee separation events. To properly terminate benefits for employees who are no longer eligible due to their separation of employment and ensure that COBRA notification is provided to employees as required by law with the aim to enable district manager healthcare financial cost.

Business Process Steps Step # Step Description Executed By 1. • Resignation-Employee processes an online resignation

through the employee portal. If the employee fails to process an online resignation the supervisor can email Employee Enterprise regarding the separation

• Retirement-Benefits Associates provide employee enterprise

with a paper copy of the notification of retirement either walking it over or via scan and email that employee is retiring and the effective date

• Termination or For cause separation- Labor relations sends

an email to Employee Enterprise

• Death-Active Benefits Associates email Employee Enterprise regarding the death of an active employee. Retirement Benefit Associates email Employee enterprise for the death of a retired employee.

• Audits-Due to an audit it may come to the attention of the

district that an employee is no longer actively employed o and an email or report may be sent to Employee Enterprise to process a termination.

• RIF’s- A list of employees who are being separated may be

sent to Employee Enterprise to process. In all cases Employee Enterprise needs information in writing to process the separation. This process was likely documented by that department; their process feeds this process.

Employee, Supervisor, Retirement Benefits Associates Active Benefits Associates, Other district personnel

2. Employee Enterprise team receives notification via email from the workflow from the resignation entered in the portal or one of the means above that the employee is separating and the effective date. Employee Enterprise enters this data into APECS once the pay period of the separation date arrives.

Employee Enterprise Team

3. File transfer from APECS to ChoiceLinx- bi-weekly on Friday’s. System 4. File transfer to Vendors from APECS- Tuesday’s and Thursday’s to

Cigna (medical and dental), at least once a week to all other vendors- Davis Vision, The Standard (LTD), CPN (Flex), MetLife (Basic Life), and Concern (EAP).

System

5. File transfer to Cushion from ChoiceLinx-bi-weekly. System 6. Information is sent to surviving spouses of retirees. Benefits Associate

Page 15: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

2

Business Process Details As-Is Inputs: Separation Notification with reason, File data reflecting the separation date

As-Is Outputs: Separation information, List of inactive employee, Notification to Spouses

As-Is Systems: APECS-Payroll system, ChoiceLinx, Vendor systems, Cushion system (COBRA)

As-Is Controls: None

As-Is Interfaces: None

As-Is Reports: None

As-Is Statutes: COBRA

Business Process Map

Page 16: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN005 Benefits Termination

Executive Summary This process relates to benefits processing triggered by employee separation events. To properly terminate benefits for employees who are no longer eligible due to their separation of employment and ensure that COBRA notification is provided to employees as required by law with the aim to enable district manager healthcare financial cost.

Process Issues

1. There are cases where employees are simply not terminated in APECs, allowing benefits to remain in force. While this not specifically a benefits process issue, the result can cost the district thousands of dollars in premiums until the issue is discovered.

2. Errors in the vendor file load can at times prevent coverage from being fully termed in vendor systems such as Cigna.

Business Process Recommendations

• The district needs a stricter and real-time position management policy and system. In such a system, cost centers are given a total FTE count by job class that cannot be raised without additional funds and budget approval. In the event of a missed termination, the cost center would not be able to replace the employee with another employee because they would not have a vacant position in which they could place the employee. This recommendation illustrates the downstream effect of a position management system that lags hires and terminations by such a great amount of time that it becomes useless in preventing those things it is meant to prevent.

• Personnel Actions for certain actions such as terminations and transfers should originate online, and at the schools and departments. Online actions allow us to trigger downstream actions immediately. These personnel actions should be limited and easy to execute. Employees should also have the option of resigning online.

• Once personnel actions are enabled and optimize so not to be a burden to the school personnel the policy of 24-hour notification of any terminations, AWOL, walk-offs, etc. via the personnel action system should be enforced by the members of the Superintendents Cabinet.

• A new ERP will require new vendor files to be developed and maintained. During the discovery phase of the implementation, it is very important that the Benefits department review and test files to the vendors. When issues do occur, SCSD staff should have the ability to fix the integration, or ask the vendor to do so.

• Consider allowing the written process of separation to be moved to the personnel action. Personnel actions are date and time stamped in most systems, showing the originator of the process. Paper documentation is not necessary, and is rarely required in most modern companies, as the electronic trail is more complete, and easier to obtain. This does not absolve us from thorough documentation. It only moves that responsibility to the ERP system from the slow paper-based world.

• Terminations should happen as soon as possible in the system, with substantiating information to follow. False terminations are relatively few and far between, and are easily reversed if done prior to the next pay period.

Page 17: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BEN006 FMLA

Page 18: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN006 FMLA

Business Process Description FMLA is a federal law that entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions. This process also includes absence management.

Business Process Steps Step # Step Description Executed By 1. Review and approve Leave of Absence requests. Leave Administrator 2. Load employees’ approval data in Microsoft Access Database and

ZOHO. Leave Administrator

3. Input employees’ leave information in APECS. Leave Administrator 4. Update employees’ status in APECS upon their return to work. Leave Administrator

Business Process Details As-Is Inputs: No external inputs identified.

As-Is Outputs: No external outputs identified.

As-Is Systems: APECS, Microsoft Access Database, ZOHO

As-Is Controls: None

As-Is Interfaces: None

As-Is Reports: None

As-Is Statutes: FMLA

Page 19: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

2

Business Process Map

Page 20: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN006 FMLA

Executive Summary FMLA is a federal law that entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions. This process also includes absence management.

Process Issues The process of FMLA is a mix of an Access Database, APECS, ZOHO and manual tracking. FMLA and other absence compliance laws that can be grouped here are notoriously difficult to track, given the multiple qualifications, rolling windows for compliance, and high consequences for non-compliance.

Business Process Recommendations

• Absence management compliance tracking needs to be accomplished in the ERP system. Many of these systems contain Absence Case Management, which allows for the placing of the employee on FMLA after a series of questions to determine if they are qualified.

• The ERP system should track FMLA in hours with 480 hours being the limit. This allows for greater flexibility, allowed by law, for employees to take the smallest amount of time necessary to attend to their FML.

• Intermittent FMLA should be able to be entered into a timesheet or payroll so that partial days worked vs. partial days on leave are distinguishable to the FMLA bank itself, and to any reporting in the future.

• FMLA is a protected leave, and should not be counted against an employee, regardless of whether or not it paid.

Page 21: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BEN007 Retroactive Benefits

Page 22: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN007 Retroactive Benefits

Business Process Description This process ensures that employees are charged accurately for benefits when changes, enrollments, and cancellations take place; this may require processing adjustments for any missed premiums or submitting a refund request if the employee has been charged too much. The Active Benefits Associates are the owners of this process along with the Benefits Manager. Properly charging employees for benefits helps the district to manage healthcare financial costs. Two actions happen:

• The adjustment entry allows the payroll system to actually take the amount from the employee check.

• The Refund entry allows the payroll system to credit the amount to the employee check. Business Process Steps Step # Step Description Executed By 1. Review the current benefits elected by the employee in ChoiceLinx. Benefits Associate 2. Review the prior benefits. Benefits Associate 3. Determine if an adjustment or refund is needed by calculating the

amount. Benefits Associate

4a. ADJUSTMENT-Enter the Adjustment into the APECS deductions and benefits screen for each benefit (medical, dental, vision, etc.) and save each adjustment.

Benefits Associate

4b. REFUND-Complete a Refund request, submit to our manager, and await approval. REFUND-Enter the Refund into APECS deductions and benefits screen for each benefit (medical, dental, vision, etc.) and save each adjustment.

Benefits Associate Benefits Manager

5. Signs the refund form and prints a paper copy of the screen and returns it to the Benefits Associate.

Benefits Manager

6. Email or call the employee to provide details of the adjustments or refunds.

Benefits Associate

7. Electronically save all documents related to the refund or adjustment.

Benefits Associate

Business Process Details As-Is Inputs: No external inputs identified.

As-Is Outputs: Current Cost, Prior Cost, Completed Refund Request

As-Is Systems: ChoiceLinx, APECS-Payroll system

As-Is Controls: None

As-Is Interfaces: None

As-Is Reports: None

As-Is Statutes: None

Page 23: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

2

Business Process Map

Page 24: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN007 Retroactive Benefits

Executive Summary This process ensures that employees are charged accurately for benefits when changes, enrollments, and cancellations take place; this may require processing adjustments for any missed premiums or submitting a refund request if the employee has been charged too much. The Active Benefits Associates are the owners of this process along with the Benefits Manager. Properly charging employees for benefits helps the district to manage healthcare financial costs. Two actions happen:

• The adjustment entry allows the payroll system to actually take the amount from the employee check.

• The refund entry allows the payroll system to credit the amount to the employee check. Process Issues

1. This process is time consuming as it has to be completed for every approved change, enrollment or cancellation of benefits. Although the time can vary depending on the circumstances every instance of change needs to be reviewed to ensure no adjustments or refunds are needed.

2. We require a paper approval process. This only serves to slow the entire process down to the point where more adjustments need to be made.

3. Calculations are manual and prone to inconsistency. Business Process Recommendations

• There are two major items that we need from a new ERP system that will contribute to improving this process immensely. The first item is proper and robust effective dating of the employee actions that affect employee benefit eligibility. The second item is the ability to hold a bucket of money owed but not deducted, regardless of the case. Given that ERP systems calculate payroll benefits deductions based upon the benefit plan and coverage of the employee, changes to the HR status of the employee, even if retroactive, should force a recalculation of employee benefits from the effective date of the action forward. If the recalculation results in a refund to the employee, the difference should be automatically added to the employee’s check (or similar deduction reduced). If the resulting calculation results in the employee owing the district money, the system should place that amount in a retro bucket, by deduction code (employer or employee) and reduce subsequent paychecks by a predetermined limit (percentage or amount) until the employee’s liability is resolved. Approval for the benefit deduction or refund should not be necessary, only the personnel action.

• Benefits adjustments that deviate from the first recommendation should be special cases. The retro bucket should be adjustable, either directly via an ERP page, or via the pay line and positive or negative adjustments to the deduction. These adjustments should require a comment that includes the name of the adjuster and the reason for purposes of audit.

Page 25: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BEN008 Benefits Reconciliation

Page 26: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN008 Benefits Reconciliation

Business Process Description This process is performed so the benefits system tracks and reports debit and credit adjustments to premiums based on eligibility changes made in each monthly billing cycle. The desired outcome is to track eligibility changes, and provide a monthly billing report to reconcile with audit enrollments. The Benefits Office would be the owner of the process. However, currently this process is not in place. The customers of the business process would be Human Resources Leadership, Superintendent, and the Finance Department. The finance department wants to track what’s coming in and what’s going out of the insurance fund to include employees covered and payed premiums.

Business Process Steps Step # Step Description Executed By No steps, as this is a desired outcome of re-engineering this

business process.

Business Process Details As-Is Inputs: No external inputs identified.

As-Is Outputs: No external outputs identified.

As-Is Systems: APECS-Payroll system, APECS- Retiree system database

As-Is Controls: None

As-Is Interfaces: None

As-Is Reports: None

As-Is Statutes: None

Page 27: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN008 Benefits Reconciliation

Executive Summary Benefits reconciliation, in addition to the description provided by the preceding As-Is process description, is used to assure that the amount billed to the district by the providers is what the district is accounting for via its employer and employee deductions. In theory, they should never deviate. As we hire employees in to our ERP, they are sent to ChoiceLinx, our third party administrator, who determines eligibility, enrolls the employee, and sends enrollment back to the ERP. Payroll deductions then deduct according to the amounts that correspond to the benefits elections given to us. Benefits reconciliation is often complicated by the crossing of pay check dates, eligibility dates, coverage dates, and vendor billing statements. Adding to the confusion is the complexity of charging various benefits to the various funds, which then need to be reconciled with the insurance fund.

Process Issues There is not a system of benefits reconciliation.

Business Process Recommendations

• The ERP implementer typically struggles with the accounting involved in a large school district that is self-funded. It is a difficult and arcane world to navigate, and not something that most ERP consultants are forced to deal with on a regular basis. It is therefore very important that during discovery, a good deal of time is dedicated up-front to the chart-of-accounts structure at SCSD, including: inter-fund transfers as they apply to employer and employee paid benefits deductions, grant accounting as it relates to the charging of benefits, the timing and necessity of re-classing benefit costs that are not allowed to charge to certain funding sources, and the receipt of payment for benefits from the benefits billing system. Accurate setup of all of these components is necessary for effective benefits reconciliation.

• Create an Uncollected Premiums Report. This report adds all employer and employee-paid deductions to the retroactive bank for those deductions, and returns a total amount of deductions missed each payroll. This report is the equivalent of an “uncashed check” listing when reconciling a bank account. If the total expected payment from the benefits eligibility (vendor provided) minus the total deduction from payroll, plus the total amount in the benefits arrears bucket for that deduction code do not equal zero for the employee, the calculated discrepancy should appear on this report.

• Create a Vendor Payment Billing Report. The vendor payment reports should be run from the ERP with no outside calculation necessary. The primary difference that this report has over the deduction register from payroll is that it should total the actual deduction amounts taken over the same period of time as do the vendors’ invoices.

• Implement a Benefits Arrears Bucket. This is a necessary component in getting an accurate accounting of your net deduction obligation vs. what was deducted via payroll.

Page 28: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BEN009 Affordable Care Act

Page 29: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN009 Affordable Care Act

Business Process Description This process ensures that any employee working 30 hours or more may obtain health insurance through Shelby County Schools within a 1 year look back period. APECS is utilized for SCSD employee data. The Charter Schools sends a .csv. File to the HRIS Specialist. The HRIS Specialist combines all Charter Schools and post one .csv. File to Mercer secure site.

Business Process Steps Step # Step Description Executed By 1. IT generates CORE and HOURS files of District employee data and

places the file on a shared folder to be FTP’d over to Mercer every month along with the consolidated Charter School files mentioned below.

Tech Services

2. Charter schools submit their monthly CORE and HOURS files containing their employees’ data to HRIS.

HRIS

3. All of the Charter schools monthly CORE and HOURS files are consolidated into 1 CORE and 1 HOURS file.

HRIS

4. The consolidated monthly CORE and HOURS files are checked for errors.

HRIS

5. The consolidated monthly CORE and HOURS files are placed on the shared folder to be FTP’d to Mercer.

HRIS

6. The monthly CORE file is processed and if errors still exist, Mercer will send notification of errors along with an error file of the errors that errors exist and where they are located within the file (line number).

ESR Support, Mercer Customer Support

7. Once all the errors have been corrected the file is saved as a corrections file to overwrite existing data and placed on the shared folder to be FTPd to Mercer.

HRIS

8. Once the CORE file processes error free then the HOURS file is processed with the same process as the CORE file. If errors exist in the monthly HOURS file, Mercer will send notification of errors along with an error file of the errors that errors exist and where they are located within the file (line number).

ESR Support

9. Once all the errors have been corrected the file is saved as a corrections file to overwrite existing data and placed on the shared folder to be FTP’d to Mercer.

HRIS

10. When both files are error-free and processed we will receive an email notification from ESR Support that the files for the month have been generated and posted on Connect (Mercer’s website) along with a link to the Monthly Reports.

ESR Support

Business Process Details As-Is Inputs: CORE file, HOURS file

As-Is Outputs: No external outputs identified.

As-Is Systems: APECS, Mercer System

Page 30: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

2

As-Is Controls: None

As-Is Interfaces: None

As-Is Reports: None

As-Is Statutes: Affordable Care Act

Business Process Map

Page 31: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN009 Affordable Care Act

Executive Summary This process ensures that any employee working 30 hours or more may obtain health insurance through Shelby County Schools within a 1 year look back period. APECS is utilized for SCSD employee data. This is primarily a process driven by Mercer, as they conduct the calculation on our behalf with data provided by Tech Services.

Process Issues None identified.

Business Process Recommendations

• We will likely have a choice in the new ERP whether we want to continue using Mercer, or we would like to make the ACA determination ourselves via the built-in functionality. If we remain with Mercer, reports replicating the CORE file will need to be added to the Statement of Work with the implementer. If we elect to do it ourselves, the details on lookback periods, monthly hours, etc. will need to be communicated to the implementation team.

Page 32: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BEN010 Annual Enrollment

(Open Enrollment)

Page 33: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN010 Annual Enrollment

Business Process Description Annual enrollment is a benefits process that enables employees to review their benefit information annually for changes, cancellations, and enrollment in the Section 125 benefits such as Medical, Dental, Vison, and Flex. This process from planning through execution and post enrollment administrative work takes approximately 6 months. We usually start in January of each year getting healthcare projections from our consultants which we may not receive until March, weekly meeting discussing cost and design based on the Superintendent goals for budget. If the Superintendent states that he wants to see a 10% cut for benefits, the consultants will do various recommendation for review. The CHRO will take the recommendations to the Superintendent. The Superintendent will approve or deny the recommendation. If the Superintendent approves the recommendation, it goes to the Governing Board for information only. The Governing Board does not have to vote on the employee benefits. A presentation to the Governing Board of the recommendation is usually done in April or May and Open Enrollment commences in July.

Business Process Steps Step # Step Description Executed By 1. Planning- This includes creation and review of several options for

plans and cost and estimates and other data created by vendors; and review and approval of these by the board of education, superintendent, and Chief of HR . This also includes creation of a timeline for open enrollment and an overall plan of execution for the project.

Benefits Manager

2. Documentation Review & Creation. Benefits Associates and Benefits Manager

3. Training & Outreach. Benefits Associates 4. Benefits System Changes, Testing, etc. to format System window. Vendor/ Benefits

Associates 5. Mail out of documents. Mailroom 6. Window opens and Customer Service. Vendor/ Benefits

Associates 7. Email, Text, and Phone Reminders. Benefits

Manger/Communications Department

8. Data Review-unconfirmed enrollments , late enrollees, etc. Benefits Associates 9. Enrollments to carriers. Vendors 10. Payroll file acceptance and processing. Benefits Manager 11. Close out, lessons learned, etc. Benefits Associates

Business Process Details As-Is Inputs: Open Enrollment Guide, Employee Enrollment File

As-Is Outputs: Enrollment Confirmation/Cancellation Notice

As-Is Systems: ChoiceLinx, APECS-Payroll system, Vendor systems

As-Is Controls: None

As-Is Interfaces: None

Page 34: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

2

As-Is Reports: None

As-Is Statutes: None

Business Process Map

Page 35: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN010 Annual Enrollment

Executive Summary Annual enrollment is a benefits process that enables employees to review their benefit information annually for changes, cancellations, and enrollment in the Section 125 benefits such as Medical, Dental, Vison, and Flex. This process from planning through execution and post enrollment administrative work takes approximately 6 months.

Process Issues The District has considerable expertise dedicated to this process via ChoiceLinx, the vendors themselves, and other benefits consultants. Larger recommendations regarding the timing of enrollment, rates, or eligibility will be left to those who specialize in the District’s specific case.

Business Process Recommendations

• A great deal of frustration and work can be saved by entering the new benefit year deduction changes in early. This requires a system that allows you to effective date next year’s rates.

Page 36: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BEN011 Leave of Absence

(without Pay and Benefits)

Page 37: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN011 Leave of Absence (without Pay and Benefits)

Business Process Description This purpose of this process is to ensure that employees are loaded into unpaid status in a timely manner in an effort to avoid any overpayments to employees thus minimizing the negative impact on the District’s budget. Additionally, it will relieve employees from the hassles associated with repayments as a result of any overpayments that may have occurred.

Business Process Steps Step # Step Description Executed By 1. Manually load unpaid status on the Primary screen in APECS. Leave Administrator 2. Load event screen with paid/unpaid dates. Leave Administrator 3. Load Job and Payment line with last date in paid status, leave type,

unpaid (end reason). Leave Administrator

Business Process Details As-Is Inputs: No external inputs identified.

As-Is Outputs: No external outputs identified.

As-Is Systems: APECS

As-Is Controls: None

As-Is Interfaces: None

As-Is Reports: None

As-Is Statutes: None

Page 38: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN011 Leave of Absence (without Pay and Benefits)

Executive Summary This purpose of this process is to ensure that employees are loaded into unpaid status in a timely manner in an effort to avoid any overpayments to employees thus minimizing the negative impact on the District’s budget. Additionally, it will relieve employees from the hassles associated with repayments as a result of any overpayments that may have occurred.

Process Issues No issues were reported.

Business Process Recommendations

• Make sure that the ERP system allows for the proper proration or payout of teachers’ salaries when going on an unpaid leave that is not FMLA eligible.

Page 39: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BEN012 Retirement Tracking

Page 40: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN012 Retirement Tracking

Business Process Description Retiree information is used to inform TCRS on the benefit deductions that would be withheld from the retiree’s pension and also to inform and obtain Medicare reimbursements for retirees who are Medicare eligible. Retiree information is currently being used by the HR and benefits department for various purposes including accounting for all board costs associated with retiree benefits and employment history. A retirement database was recently created in APECS, the desired outcome of a new system would be to deliver the same functions such as accurate record keeping.

Business Process Steps Step # Step Description Executed By 1. Reference active information and demographics as needed in

APECS to properly certify TCRS Retirement Application (years of service, insurance eligibility, salary, # of months worked, #of days worked, unused sick time.

Retirement Specialist, Benefits Associate

2. Take copy of Retirement Notification to the Employee Enterprise Team and Staffing.

Retirement Specialist, Benefits Associate

3. The Employee Enterprise Team enters the retirement information into APECS.

Employee Enterprise Team

4. Automated process in place to terminate active employees in APECS which feeds to ChoiceLinx, which feeds to Cigna.

System

5. A retiree profile is created in the retiree database in APECS. System 6. Enter updates in retiree database in APECS as needed (address

changes, status changes – cancellations, rate changes, etc.). Retirement Specialist, Benefits Associate

7. An outbound file is created for TCRS for premium deductions each month (medical/dental/vision).

System

8. TCRS monthly billing file is created and then put on the server for IT (Reginald Harris) to send to TCRS by the 10th of each month.

Retirement Specialist

9. An outbound file is pending creation for Medicare reimbursements. System 10. Reports generated to assist benefits in maintaining records. Such

as, board costs, life insurance amounts, medical direct pay, missing TCRS ID #, Age-in reports (Post 65), Duplicate entries error report, local pensioners.

System

Business Process Details As-Is Inputs: No external inputs identified.

As-Is Outputs: No external outputs identified.

As-Is Systems: APECS, ChoiceLinx, Cigna Access, Davis Vision

As-Is Controls: None

As-Is Interfaces: None

As-Is Reports: None

As-Is Statutes: None

Page 41: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

2

Business Process Map

Page 42: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN012 Retirement Tracking

Executive Summary Retiree information is used to inform TCRS on the benefit deductions that would be withheld from the retiree’s pension and also to inform and obtain Medicare reimbursements for retirees who are Medicare eligible. Retiree information is currently being used by the HR and Benefits department for various purposes including accounting for all board costs associated with retiree benefits and employment history. A retirement database was recently created in APECS, the desired outcome of a new system would be to deliver the same functions such as accurate record keeping.

Process Issues

1. The inability to review all of the employment history – or old history (e.g. last day worked, termed and rehire dates, salary information).

2. The inability to review accurate Legacy MCS information. 3. The generation of accurate reports (eg. the number of retirees with and without insurance, etc)

is not possible without waiting for custom reports. Business Process Recommendations

• Once the new ERP is selected, we will need to review the efficacy of the custom-built retiree database recent created and introduced. ERP systems off the shelf will have difficulty meeting all of the various requirements of school district and Tennessee retirement without the inclusion of a pension module and some modification. If a “Cloud” solution is chosen, subscription costs are typically calculated on headcount in the system. Retiree tracking could potentially increase the cost of such a system to make it prohibitively expensive.

• If the District decides it would like to incorporate this functionality into an ERP, then it is wise to wait until a second phase.

Page 43: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BEN013 Return Employee from Leave

Page 44: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN013 Return Employee from Leave

Business Process Description This process exists to ensure employees are put back into active status upon return from paid/ unpaid leave. The effectiveness of this process has significant value to restoring employee benefits such as their pay and sick/vacation time accrual.

Business Process Steps Step # Step Description Executed By 1. Manually load the Primary screen in APECS with the effective return

to work date. Leave Administrators

2. Load Events screen to active status. Leave Administrators 3. Load Job and payment line to reflect active status. Leave Administrators

Business Process Details As-Is Inputs: No external inputs identified.

As-Is Outputs: No external outputs identified.

As-Is Systems: APECS

As-Is Controls: None

As-Is Interfaces: None

As-Is Reports: None

As-Is Statutes: None

Page 45: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BEN013 Return Employee from Leave

Executive Summary This process describes entering requests for paid Leave of Absence in ERP. This is needed in order to keep employees’ allotment of sick, personal and vacation days accurate and to know if/when an employee should be put on unpaid status in an ERP system. The process for returning an employee from leave of absence is generally a standard personnel action.

Process Issues We don’t see any significant issues with this process that need to be solved.

Business Process Recommendations

• Provide a clear point of contact for employees with the District for all questions that may occur during their return from leave. Oftentimes employees return with new disabilities that may require accommodation, questions on their benefits, or changing dates of return.

• Use the ERPs document management system to store copies of documentation related to the leave case in general. These might include doctor’s notes, written requests, etc.

• Create an employee checklist, similar to the one used at onboarding, to assure that the employee has all necessary items and access upon return. This includes things like system security, keys, badges, laptops, and restored benefits.

• Leaves should be case-based, and allow an area to request accommodations in case the employee has a new disability.

• As the leave day approaches, proactively contact the employee to see if the expected date for return is still valid.

Page 46: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BUD001 Grant Budgets

Page 47: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BUD001 Grant Budget

Business Process Description This process exist to ensure grant budgets are processed in time for approval by the governing board as it results in an increase to the overall district budget.

Business Process Steps Step # Step Description Executed By 1. Award letter is given by the grantor to department. Grantor 2. Manger reviews then prepares documentation for amendment. Grant Manager 3. Budget receives along with proper documentation to process. Budget Center

Manager 4. Once processed in budget, CFO receives and approves. CFO 5. Superintendent receives and approves. Superintendent 6. Board receives and give the final approval. Governing Board 7. After approval, Budget then loads budget to APECS. Budget

Business Process Details As-Is Inputs: Grant Award Letter

As-Is Outputs: None

As-Is Systems: APECS

As-Is Controls: None

As-Is Interfaces: None

As-Is Reports: None

As-Is Statutes: None

Page 48: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

2

Business Process Map

Page 49: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BUD001 Grant Budget

Executive Summary This process exist to ensure grant budgets are processed in time for approval by the governing board as it results in an increase to the overall district budget.

Process Issues None identified.

Business Process Recommendations

• This process is straightforward, as long as the new ERP is able to track grants and grant years that do not correspond to the fiscal year. These questions will be asked of the proposing vendors.

Page 50: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BUD002 Create Original Budget

Page 51: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BUD002 Create Original Budget

Business Process Description By definition a budget is an estimate of revenues and expenditures for a given year. The district’s general fund budget is allocated for a fiscal year beginning in July and extending to June of the following year. Some notable exceptions are certain Federal funds which operate on October to September fiscal year as well as certain grants or capital budgets which may extend for multiple years and perhaps on their own fiscal year calendar. District funding is derived from multiple sources including local taxes, county bonds, State equalization assistance, and grants. Shelby County assesses a property tax earmarked for education. By State law, local funding must comply with a “maintenance of effort” where per pupil funding cannot decrease from the previous year. Revenues are budgeted based upon enrollment projections while considering other factors such as mobility, birth rates, and/or shifting demographics. State equalization is primarily derived from State sales tax collection. The district allocation is determined in large part by various state indices.

Business Process Steps Step # Step Description Executed By 1. Provide enrollment projections, calendar, assumptions, etc. to BCM. Budget Manager 2. Prepare departmental budget. Budget Center

Manager 3. Prepare, review, and consolidate individual budgets. Budget Manager 4. Revise consolidated budget. CFO 5. Review consolidated budget. Superintendent of

schools 6. Review and approve. Board of Education 7. Review and approve. County

Commissioners Business Process Details As-Is Inputs: Enrollment information, previous budget data, previous expenditure data

As-Is Outputs: Adopted Budget

As-Is Systems: Excel, Access, APECS

As-Is Controls: Review by Budget, CFO, Superintendent, Approval by Board of Education, Approval by County Commissioners

As-Is Interfaces: None

As-Is Reports: None

As-Is Statutes: None

Page 52: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

2

Business Process Map

Page 53: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

1

BUD002 Create Original Budget

Executive Summary The outcome of the annual budget process is to produce a budget that provides significant value to the taxpayer in terms of providing education to students and to do so in a very transparent way. Although simple in concept, the process of creating a budget and getting approval is a long and arduous task with literally thousands of stakeholders involved. Key considerations during the budget process include enrollment projections for each school, educational priorities both the staffing and programs, and available funding from various funding sources. The process begins with distributing enrollment projects, previous year data, and other pertinent data to Budget Center Managers who are expected to review the information and prepare budget requests based upon known changes in enrollment, changing demographics, evolving programs, community engagement, and various other factors. Those individual budgets are gathered and consolidated by the Budget department to prepare a District-level budget for review by the CFO, Superintendent, Board of Education, and the County Commissioners.

Process Issues The process as described is conducted outside of the core business system on paper, in Excel spreadsheets and within Access databases. Since all of this effort is conducted without the benefit of a true budget system that is integral to the financial management system, there is no opportunity for system validation of account codes as well as no method for electronic routing and approval. This method is inefficient as the information created in the spreadsheets and Access databases will ultimately have to be re-entered in APECS to establish the initial budget for the year. Since all of this is conducted on paper, there is also a potential for the paperwork to get lost, misplaced, or ignored. The possibility of data input errors as the transactions are ultimately entered into APECS also exists.

Business Process Recommendations

• Automation of the process through the implementation of a budget system is the key to process improvement. Ideally, the budget system would be a component of the ERP system and therefore would be tightly integrated.

• Automation would provide the means to validate the account codes for accuracy, could provide electronic routing and approval, and would overall expedite the process of creating the budget.

• Automation would also provide a means of linking actual position/benefit data to the budget therefore eliminating the manual processing required and could link the approval of funds to positions ensuring each position is properly accounted and funded.

Page 54: BEN002 Benefits Enrollment (including Qualifying Events) Analysis pg... · ChoiceLinx is the benefits enrollment system provide to SCSD through CIGNA. ... BEN002 Benefits Enrollment

BUD003 Maintain Chart of Accounts