By Betty Feinstein, Kaiser Permanente
Kaiser Permanente has been providing health care to the public since 1945 and currently employs more than 170,000 people across 11 regions and business units in eight states and Washington, D.C.
The Benefits Administration Team is one of seven operations located at the HR Service Center (HRSC) in Alameda, Calif. Formed in 2005, the team, with a staff of 13, supports all regions and business units across Kaiser Permanente. The team’s mission is to ensure that benefit enrollments for Kaiser Permanente employees are administered accurately and timely.
Kaiser Permanente is currently on PeopleSoft 9.1 – Benefits Administration, which includes: 137 automated programs, 55 manual programs, 77 event classes, 733 event rules and 1,220 eligibility rules.
BAR
Benefits Automated Reprocessing (BAR) is a systematic approach to reprocessing flagged closed benefits administration events and identifying fallout events (exceptions) for manual evaluation.
In May 2008, there were more than 33,000 events with out of sequence and/or job flags. Utilizing additional four to six contractors to manage the flags, the staff manually cleared 36,000 flags between October 2009 and July 2010. By the end of 2011, even with the extra contracting resources, the average daily number of flagged events was still more than 10,000. The team was reprocessing 1,200 EM and 100 OE events daily.
BAR was implemented in January 2012 as a collaborative effort by the benefits administration and IT/development teams, who worked together on business requirements, functional design, testing and problem resolution.
BAR will reprocess a flagged event if:
- The event prior to the flagged event is in Finalized – Prepared None (FP) status, or a PAY event in either FP or Finalized Enrolled (FE) status
- The BAS Process Status of the flagged event is Program Elig Assign None (AN), Finalized Benefit Pgm None (FA), FE or FP
BAR will not reprocess an event if:
- There is pending BAS activity for the employee
- The event prior to the flagged event is not FP and is not a PAY FE event
- The flagged event is disconnected or voided
- There is an open event before or after the flagged event
- The benefits system on the top of stack = base benefits
- There are multiple flagged events on the same day
BAR has two functional routines:
- Routine 1: evaluates each employee and whether flagged events can be processed by BAR
- Routine 2: determines what happens to events that can be processed by BAR
Benefits Administration and BAR run four times nightly in order to allow a minimum of two eligible flagged events to be reprocessed each night for an employee. To support BAR, customized BAS PARTIC tables were created to store reprocessed data.
- KP_BAR_BAS_PART - KP BAR BAS Participant
- KP_BAR_BAS_PLAN - BAR BAS Participant Plan
- KP_BAR_BAS_OPTN - BAR BAS Participant Option
- KP_BAR_BAS_COST - BAR BAS Participant Cost
- KP_BAR_BAS_DPND - BAR BAS Participant Dependent
BAR reports produces two reports:
- Events Not Processed Report – lists employees whose events are evaluated by BAR but not processed. Explanations are included for why each employee was not processed.
- Event Exceptions Report – lists employees whose events were evaluated by BAR but where reprocessing could not be completed.
All data from reprocessed BAS_PARTIC records is saved, compared and restored from the customized tables.
If reprocessed BAS_PARTIC data is different from the saved data on the customized tables, BAR will not complete reprocessing and writes the employee to the exception report.
KP_BAR_Processed is a field on the KP_BAR_BAS_PART record and contains valuable information to track how BAR processes events.
Y = Processed
- Employee’s custom BAS PARTIC record rows have been compared with the BAS_PARTIC_% rows
- No mismatch found
- Event successfully reprocessed by BAR
B = Ben Admin
- Employee’s event was closed by Benefits Administration
- Scenario: 1) Event is in open/assigned status after BAR runs; 2) Event status changes to closed/FP instead of open/PR after Benefits Administration runs; 3) Employees are not written to the exception report
I = In Progress
- Employee’s custom record rows have been compared with the BAS_PARTIC_% rows
- Mismatch is identified and reported in the exception report
- Waiting for action from the analysts
N = Not Processed
- Employee’s data inserted into custom tables on fourth BAR run
- Data not yet compared with the BAS_PARTIC_% tables
M = Manual
- Event opened by BAR is closed by Benefits Administration analysts
- Scenario: Event has Open/Prepared status at the end of the fourth Benefits Administration run; Analysts query emplids with open/prepared on BAS_PARTIC record and KP_BAR_PROCESSED flag = N; Events are manually processed to closed/finalized enrolled; During the next BAR run, the N value is updated to M, indicating a manual update by the analysts, and the COMPLETED flag is updated to Y
BAR impacts
- Reduction in number of flagged events: Prior to BAR running regularly, there were 15,183 flagged events on Jan. 3, 2012; Three months after implementing BAR, there were 655 flagged events.
- Reduction in flags has decreased incorrect benefits enrollments by timelier processing of flagged events requiring analyst involvement
- Benefits Administration analysts’ time is freed up to work on more analytical issues/projects than manually clearing flags that do not impact benefits enrollments
Headcount was reduced by 30 percent (from 20 to 13 FTE), resulting in more than a million dollars savings annually and the elimination of the need for contract labor.
BAR has proved to be a very effective tool to help with reprocessing flagged events and is now an integral part of the daily Benefits Administration batch process.
Betty Feinstein is currently a business analyst specialist at Kaiser Permanente in the Human Resources Technology group and has worked with the Benefits Administration product since 1995. She has been with Kaiser Permanente since 2005, contributing in many projects that have enhanced how Benefits Administration is used in the Kaiser Permanente system. As a PeopleSoft employee from 1995 through 2004, Betty wrote the curriculum for the Benefits Administration training materials, which remains the basis for training offered today.