HCA Vendor Partnership Conference
Presented by: Xerox
Tuesday, September 25, 2012
September 25, 2012
Agenda• 9:00 AM Opening Remarks - Sarah Shoiock
• Health and Group Benefits Team (H&GB)• 9:30 AM Vendor Team Introductions - Jennifer F. Johnson• Team Roles and Responsibilities
• Financial Control Group• Premium Reporting Team• Vendor Liaison• Vendor Operations Team
• 10:00 AM Vendor Eligibility Process - Gina Schobel • Overview• Non-Annual Enrollment Activities• Annual Enrollment Activities• AE 2013 Eligibility File Schedule
• 12:00 PM Break for Lunch
• 1:00 PM Vendor Reconciliation Process - Jennifer F. Johnson• Overview• Discrepancy Categories• Research• Final Steps
• 1:45 PM Premium Payment Process - Jennifer F. Johnson• Overview
• 2:30 PM Vendor Liaison Process - Jennifer F. Johnson• Overview• Verification of Coverage Process• Interface and Emergency Update Method
• 3:30 PM Closing Remarks - Jennifer F. Johnson • Xerox Contacts
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September 25, 2012
Opening Remarks - Who We Are
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With sales of $22 billion, we are the world’s largest enterprise for business process and document management
• Employees: 130,000 worldwide
• History: Founded in 1906 as The Haloid Company; named Xerox in 1958 and Xerox Corporation in 1961; acquired Affiliated Computer Services in 2010
• Headquarters: Norwalk, CT
• Chairman and CEO: Ursula M. Burns
In Fortune’s recent rankings of the world’s Most Admired Companies, Xerox was ranked No. 1 in the computer industry.
September 25, 2012
Opening Remarks - Human Resource Services Capabilities
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• Employee Service Center• Workforce Administration• Employee Data Management• Payroll • Garnishment• Global Mobility• Compensation• Talent Management • Relocation • Expat Administration• HR Analytics• HR Transformation
• Full scope of Benefits Administration:−H&W−DB−DC−Equity Incentive−Deferred Cash
• Customized benefits calculator
• Event / transaction processing• Regulatory/Plan compliance• Design and implementation of
employee communication programs
• Learning strategy, assessment, content design, development and management
• Instructor led, e-learning and virtual classroom
• Learning administration and delivery
• Forecasting, reporting, logistics, and learner care
• Translation services• Tuition management services
• Communication • Compensation• Health and Productivity• HR Technology and
Administration• Human Capital Management• HR Transformation• Change Management• Retirement
HR OutsourcingTotal Benefits Outsourcing Learning Services Consulting
• Employee, Manager and HR Self Service• ACS core technology for H&W, DB and DC• Flexible and highly configurable
• On-boarding• Learning Management
Integrated self service portal• Talent Management• Compensation Management• Advanced Analytics
Document Management
Global Service Centers
• Enterprise Document Management• Document Capture−Indexing−Storage / Retention / Retrieval−Redaction
• Document Supply Chain
• Communication Engineering• Language Translation• Workflow / Compliance• Multi-channel Communication
September 25, 2012
Opening Remarks
• Health and Group Benefits Team (H&GB)• Responsible for overall client delivery• H&GB eligibility calculation module ownership and maintenance responsibilities• Subject matter experts on business rules and requirements• Primary owners and points of contact for change work• Coordination across all Xerox teams that support HCA activities
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September 25, 2012
Team Roles and Responsibilities
• Financial Control Group (FCG)• Performs data audits and reconciliations to ensure integrity of information as it is
passed to external vendors• Acts as a third-party to confirm that ongoing processes are being completed timely
and accurately• Operates independently from service delivery teams
• Recommends process improvements that benefit all clients• Maintains direct contact with Implementation and Service Center team to resolve
discrepancies• Maintains direct contact with Vendors and Clients through periodic transmission of
files and audit results• Provides monthly reporting package through the portal
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September 25, 2012
Team Roles and Responsibilities
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• Premium Reporting Team• Ensures monthly premium reports are produced accurately and timely based on
applicable rates and account structure• Establishes and maintains payment instructions• Interacts with the Service Center to resolve vendor and/or Client inquiries• Processes monthly premium payment• Resolves billing related discrepancies and delivers exceptional service, coordination
and communication• Responsible for daily service delivery, service levels, and contractual performance
standards
September 25, 2012
Team Roles and Responsibilities
• Vendor Liaison • Responsible for daily service delivery, service levels, and contractual performance
standards• Lead client meetings and internal meetings to report on performance. External
meetings will include weekly, bi-monthly, or monthly meetings with the group, carriers, and internal carrier team to facilitate data and participant issues
• Researches eligibility issues and provides verification of coverage• Resolves and responds to all Health & Group Benefits Participant and Client
inquiries that cannot be resolved through the assistance of a Customer Service Representative
• Responds to Client and / or Vendors inquiries to obtain additional information, to resolve an issue, or as follow-up or closure
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September 25, 2012
Team Roles and Responsibilities
• Vendor Operations Team• Plans, manages and controls the day-to-day vendor file activities• Responsible for daily service delivery, service levels, and contractual performance
standards• Provides proactive contact on service delivery outages, discrepancies and problems• Resolves vendor related discrepancies and deliver exceptional service, coordination
and communication
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September 25, 2012
Vendor Eligibility Process - Overview
• Ongoing Responsibilities• Oversee the ongoing processing including QA of eligibility files, discrepancy reporting, escalations,
participant issue resolution, questions / issues related to files. Manage vendors from a file perspective ensuring files have been processed by vendor
• Manage annual enrollment process
• Ongoing and Annual Enrollment File Implementations and Change Work • Discovery / requirements• Create specifications• Build file - coding• Establish FTP connectivity - set up / test with Vendor• Develop / modify custom query (if required)• Generate file• Transmit file to Vendor• Xerox & Vendor full file testing• Xerox & Vendor term file testing (if required)• Vendor sign-off on file• Generate Production File • Transition Process
– Training development and delivery of new files and training on updates to existing files
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September 25, 2012
Vendor Eligibility Process - Non-Annual Enrollment Activities
• Production File Transmission Data
• Vendor Confirmation Loaded Files
• Vendor Follow Up
• Discrepancy Report Tracking
• Transmission Update
• Complete Research / Corrections From The Data Discrepancies
• Send Weekly Log to CSMs
• Client Reporting
• New File Implementations
• Business Requirement Definition (BRD) Enhancements
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September 25, 2012
Vendor Eligibility Process - Annual Enrollment Activities
• Vendor Discovery Conference Calls
• Confirmation Package
• BRD Enhancements
• New File Implementation
• Interface With Technology
• Testing With Vendors
• Dual Year Processing
• New Plan Year Vendor Eligibility File
• ID Cards
• Client Reporting
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September 25, 2012
AE 2013 Eligibility File Schedule
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Vendor Last Ongoing 2012 File 1st AE 2013 File 2nd AE 2013 File Expected ID Card Mailing DateAetna – Medical/Dental 12/26/2012 12/4/2012 - 12/5/2012 12/18/2012 - 12/19/2012 12/21/2012
Aetna – Medical 12/26/2012 12/4/2012 - 12/5/2012 12/18/2012 - 12/19/2012 12/21/2012
Altius 12/26/2012 12/4/2012 - 12/5/2012 12/18/2012 - 12/19/2012 12/11/2012
Aon Hewitt Consulting 12/10/2012 1/10/2013 Not Applicable Not Applicable
Benefits Recovery 10/01/2012 1/10/2013 Not Applicable Not Applicable
Blue Choice SC 12/26/2012 12/4/2012 - 12/5/2012 12/18/2012 - 12/19/2012 12/21/2012
Caremark12/26/2012 12/4/2012 - 12/5/2012 12/18/2012 - 12/19/2012
98% of them mailed out within five business days, following the eligibility load. 100% within 10 days.
CIGNA 12/26/2012 12/4/2012 - 12/5/2012 12/18/2012 - 12/19/2012 12/21/2012
Consult A Doctor12/26/2012 12/27/2012 Not Applicable
New hires submitted via the AE file on that date will be sent to the printing company on Wed. Jan. 2nd with delivery within 1.5-2 weeks after
Coventry 12/26/2012 12/4/2012 -12/5/2012 12/18/2012 - 12/19/2012 12/11/2012
Delta Dental – CA 12/26/2012 12/5/2012 – 12/6/2012 12/19/20/12 – 12/20/2012 10 - 15 business days after the annual enrollment file loads.
Delta Dental – TN 12/26/2012 12/5/2012 -12/6/2012 12/19/2012 - 12/20/2012 10 -15 business days after the annual enrollment file loads.
EyeMed 12/27/2012 12/6/2012 -12/7/2012 12/20/2012 - 12/21/2012 12/21/2012
Fidelity Lift 12/26/2012 12/5/2012 -12/6/2012 12/19/2012 - 12/20/2012 Not Applicable
Florida Blue (BCBS FL) 12/26/2012 12/4/2012 – 12/5/2012 12/18/2012 – 12/19/2012 7 business days of receipt of the annual enrollment file.
h2U 12/26/2012 12/6/2012 -12/7/2012 12/20/2012 - 12/21/2012 Not Applicable
Humana / CompBenefits 12/26/2012 12/4/2012 -12/5/2012 12/18/2012 - 12/19/2012 12/14/2012
Legal Access 12/27/2012 12/6/2012 -12/7/2012 12/20/2012 - 12/21/2012 1/1/2013
Marsh 12/27/2012 Not Applicable Not Applicable Not Applicable
Met Lift LTC 12/26/2012 Not Applicable Not Applicable Not Applicable
MetLife Dental 12/27/2012 12/6/2012 -12/7/2012 12/20/2012 - 12/21/2012 10 business days
New Directions 12/26/2012 12/5/2012 -12/6/2012 12/19/2012 - 12/20/2012 Not Applicable
PacifiCare/UHC New Vendor – Not Applicable 12/4/2012 – 12/5/2012 12/18/2012 – 12/19/2012 To be determined
Pet First 12/27/2012 12/6/2012 -12/7/2012 12/20/2012 - 12/21/2012 Not Applicable
Prudential Disability 1/2/2013 Not Applicable Not Applicable Not Applicable
Prudential EOI 12/26/2012 12/6/2012 -12/7/2012 12/20/2012 - 12/21/2012 Not Applicable
Prudential TERM 1/2/2013 Not Applicable Not Applicable Not Applicable
Rocky Mountain 12/26/2012 12/4/20/12 – 12/5/20/12 12/18/2012 – 12/19/2012 12/23/2012
Sedgwick 1/2/2013 12/6/2012 -12/7/2012 12/20/2012 - 12/21/2012 Not Applicable
Truven (Thomson Reuters) 12/10/2012 Not Applicable Not Applicable Not Applicable
UHC 12/26/2012 12/4/2012 – 12/5/2012 12/18/2012 – 12/19/2012 12/18/2012
Value Options 12/26/2012 12/5/2012 -12/6/2012 12/19/2012 - 12/20/2012 Not Applicable
VSP 12/27/2012 12/6/2012 -12/7/2012 12/20/2012 - 12/21/2012 Not Applicable
Wage Works (COBRA) 1/2/2013 Not Applicable Not Applicable Not Applicable
Wage Works (FSA) 12/27/2012 12/10/2012 To be determined To be determined
September 25, 2012
Vendor Reconciliation - Overview
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• Compares Full File from Xerox H&GB system to Full Back feed from each included Vendor
• Vendor Selection process for Reconciliation is based on participant counts for each vendor in relation to overall count
• Goal is to capture 100% of population for each major benefit• Medical• Dental• Vision • Prescription
• Completed at a minimum of two times a year
• Comparisons are done as of the same point in time (called the “snapshot date”) so all systems should reflect the same information
September 25, 2012
Vendor Reconciliation - Discrepancy Categories
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• On Xerox H&GB system file, but not on a Vendor file
• On a Vendor file, but not on the Xerox H&GB system file
• On both files, but with Data differences• SSN Differences• Participant count differences - where the number of persons covered is different
between the H&GB system and Vendor
September 25, 2012
Vendor Reconciliation - Research
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• Discrepancies are exported into an Excel workbook for research
• Reason codes are identified, and comments are noted for each discrepancy using a Comment Key
• Sample Comments• Termed / Deceased / Ineligible but incorrectly shown as eligible - Contacted
Vendor to Update / Updated H&GB System or contacted COBRA vendor to update
• Timing Issue - All systems have been reviewed and they are confirmed to contain accurate information. No additional action is required to resolve the discrepancy.
• Eligible participant not sent or incorrectly coded on Vendor Back feed. Contacted Vendor to correct for future reconciliations.
• Corrections are made to the Xerox H&GB system, and / or corrections are sent to the vendors for updates to be made to their systems
September 25, 2012
Vendor Reconciliation - Final Steps
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• FCG compiles results and internal meeting is held to discuss Reconciliation feedback
• Repeating issues are discussed and root cause analysis is pursued to ensure resolution of issues
• Final research results are summarized into a Client Package and is posted to Client Center for Client review
September 25, 2012
Premium Payment Process - Overview
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• Vendors are provided a roster that details premium amounts to be paid
• Billing discrepancies with the vendor are typically the result of timing issues related to eligibility status and changes with a members coverage election and/or coverage tier
• Xerox determines if an adjustment is required based on enrollment activity
• Retroactive adjustments are based on generic program logic with 60 day look back period
• Any adjustments (debits or credits) that impact the amount to be paid will be applied with the next premium payment
September 25, 2012
Vendor Liaison Process - Overview
• The Vendor Liaison (VL) plays a critical role in reviewing and resolving participant and carrier eligibility related issues.
• The VL facilitates issue resolution by providing information to all internal parties and acts as a liaison to third parties and customers on resolution status.
• The VL focuses on the resolution and closure of all customer service inquiries that require interaction between vendors, H&GB, and the client.
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September 25, 2012
Vendor Liaison - Verification of Coverage Process
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• Emergency Verification of Coverage (Addressed 1-24 hours)• Request by a participant to immediately update specified carrier systems with
correct enrollment information. Employee requires immediate services or life sustaining prescriptions unless otherwise contracted.
• Verification of Coverage (Addressed 48-72 hours)• A request by a participant to update the carrier with complete enrollment
information.
September 25, 2012
Vendor Liaison – Interface and Emergency Update Method
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Vendor File Frequency On-Going File Due Date
Emergency Updates (Website Access/
Email)
Aetna Weekly Tuesday E-mailBlueChoice SC Weekly Tuesday E-mailCaremark Weekly Tuesday WebsiteCIGNA Weekly Wednesday WebsiteCoventry Weekly Wednesday E-mailDelta Dental Weekly Wednesday WebsiteEyeMed Weekly Thursday WebsiteFlorida Blue (BCBS FL) Weekly Tuesday E-mail
HealthNet Weekly Tuesday E-mailHumana Weekly Tuesday E-mailMetLife Dental Weekly Thursday WebsiteNew Directions Weekly Tuesday E-mailRocky Mountain Weekly Wednesday WebsiteUHC Weekly Tuesday WebsiteValue Options Weekly Wednesday E-mailVSP Weekly Thursday Website
September 25, 2012
Xerox Contacts
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• Vendor Operations Team• Jennifer F. Johnson, VP of Leveraged Services [email protected] (856) 651-2223
• Gina Schobel, Service Delivery Manager [email protected] (862) 588-2195
• Annette Morales, Functional Analyst [email protected] (347) 275-2293
• Vendor Reconciliation• Milton Washington, Service Delivery Manager [email protected] (856) 651-2382
• Debbie McKelvey, Functional Analyst [email protected] (856) 651-2628
• Premium Payment Process• Donna Macri, Service Delivery Manager [email protected] (973) 837-3738
• Vendor Liaison• Kevin Harter, Service Delivery Manager [email protected] (502) 529-1664
• Carrie Jarret, Coordinator [email protected] (615) 953-5136
• Account Management Team• Sarah Shoiock, Service Delivery VP [email protected] (631) 813-3717• Colleen Ferderigos, H&GB Client Service Manager [email protected] (201) 440-8727
• Daniela Tumin, H&GB Client Service Manager [email protected] (973) 837-3325• Donna Toth, Call Center Site Director [email protected] (313) 673 -1806
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