1 / 21

PARTIAL CLAIM BENEFIT YEAR EARNINGS

UI INTEGRITY/IMPROPER PAYMENTS UNITED STATES DEPARTMENT OF LABOR/CONNECTICUT DEPARTMENT OF LABOR TASK FORCE October 28, 2011. PARTIAL CLAIM BENEFIT YEAR EARNINGS. KEY STRATEGIES: EDUCATE CLAIMANTS ON THE PROPER METHODS FOR FILING PARTIAL WEEKLY CONTINUED CLAIMS TO PREVENT OVERPAYMENTS

jovita
Download Presentation

PARTIAL CLAIM BENEFIT YEAR EARNINGS

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. UI INTEGRITY/IMPROPER PAYMENTS UNITED STATES DEPARTMENT OF LABOR/CONNECTICUT DEPARTMENT OF LABOR TASK FORCEOctober 28, 2011

  2. PARTIAL CLAIM BENEFIT YEAR EARNINGS KEY STRATEGIES: • EDUCATE CLAIMANTS ON THE PROPER METHODS FOR FILING PARTIAL WEEKLY CONTINUED CLAIMS TO PREVENT OVERPAYMENTS ACTION STEPS/DELIVERABLES: • DEVELOP INFORMATIONAL GUIDELINES FOR CLAIMANT • WORK WITH BRI WORK GROUP TO INCLUDE INFORMATIONAL GUIDELINES IN REVISED BRI PUBLICATION • WORK WITH SOON TO BE FORMED IVR GROUP TO DELIVER RECORDED PARTIAL FILING GUIDELINES • WORK WITH SOON TO BE FORMED WEB/EMAIL APPLICATION GROUP TO ELECTRONIC PARTIAL FILING GUIDELINES MILESTONES/TIMING: • OCTOBER, 2011/NOVEMBER, 2011 • JUNE, 2012 • JUNE, 2012 RESOURCE NEEDS: • WEB, VRU, AND PRINT • VRU AND UI TECH • IT AND UI TECH METRICS/MEASURABLE OUTCOMES: • INCREASED ACCURACY OF PARTIAL PAYMENTS

  3. COMMUNICATION/BENEFIT YEAR EARNINGS KEY STRATEGIES: • REVIEW/MODIFY CALL CENTER IVR SCRIPT ACTION STEPS/DELIVERABLES: • ESTABLISH IVR SCRIPT EVALUATION WORK GROUP • REVIEW CURRENT IVR LANGUAGE SCRIPTS • COMPOSE NEW SCRIPTS • MODIFY RECORDINGS IN ENGLISH AND SPANISH MILESTONES/METRICS: • JANUARY, 2012/FEBRUARY, 2012 IMPLEMENTATION RESOURCE NEEDS: • IT – CALL CENTER SUPPORT TIME/ENGLISH & SPANISH SPEAKING STAFF METRICS/MEASURABLE OUTCOMES: • IMPROVED COMMUNICATION WITH CLAIMANTS

  4. COMMUNICATION/BENEFIT YEAR EARNINGS KEY STRATEGIES: • BRI ANNOUNCEMENT POST IC CLAIM ON IVR ACTION STEPS/DELIVERABLES: • ESTABLISH VOICE RECORDING WORK GROUP • REVIEW Vo1P SOLUTION OPTIONS(VOICE ANNOUNCEMENT OVER LAN CARD) • IMPLEMENT VOICE RECORDING • TRAIN CSR’s ON PROTOCOL MILESTONES/TIMING: • NOVEMBER – DECEMBER, 2011 IMPLEMENTATION RESOURCE NEEDS: • DEPENDENT ON VolP SOLUTION DEPLOYMENT METRICS/MEASURABLE OUTCOMES: • INCREASED ACCURACY OF PARTIAL CLAIMS AND RETURN TO WORK INFORMATION

  5. STAFF RESOURCES KEY STRATEGIES: • INCREASE STAFFING TO MANAGE WORKLOAD ACTION STEPS/DELIVERABLES: • MANAGEMENT ASSESSMENT OF STAFFING NEEDS IN BPCU • PROPOSED STAFFING PRESENTATION • ACCEPTED STAFFING RECOMMENDATION • ADDITIONAL STAFF HIRED MILESTONES/TIMING: • APRIL – OCTOBER, 2011 • STAFF HIRED 12/2011 RESOURCE NEEDS: • EIGHT EMPLOYEES, PLUS THREE REFILLS METRICS/MEASURABLE OUTCOMES: • ADDRESS AUDIT BACKLOG; INCREASE FRAUD RECORDS, RECOUP OVERPAYMENTS

  6. EMPLOYER AWARENESS KEY STRATEGIES: • PROVIDE EMPLOYERS WITH INFORMATION PERTAINING TO RETURN-TO-WORK LAW REQUIREMENTS AND FRAUD PREVENTION ACTION STEPS/DELIVERABLES: • MESSAGING WORK GROUP REVIEW EMPLOYER MESSAGING MATERIALS DEVELOPED BY ITSC PROJECT • WORK GROUP DETERMINES LONG AND SHORT TERM TARGET MESSAGING AND VEHICLES • COMMUNICATIONS CAMPAIGN UTILIZING QUARTERLY TAX INFORMATION NOTICES • SCHEDULE SPEAKING ENGAGEMENTS WITH EMPLOYER GROUPS ON A QUARTERLY BASIS • DETERMINE PLAN FOR LONG TERM MESSAGING PRODUCTS MILESTONES/TIMING: • ONGOING • SCHEDULE SPEAKING ENGAGEMENTS 1ST QUARTER, 2012 • 3RD QUARTER, 2012 RESOURCE NEEDS: • MAILINGS/POSTAGE • STAFF TIME AND RESOURCES METRICS/MEASURABLE OUTCOMES: • PREVENT FRAUD AND IMPROVE FUND SOLVENCY

  7. RECOUPMENT KEY STRATEGIES: • WAGE EXECUTIONS/GARNISHMENTS ACTION STEPS/DELIVERABLES: • UTILIZING E-FILE PROCESS IMPLEMENTED IN MAY, 2011 • INCREASE VOLUME OF WAGE GARNISHMENTS BY INCREASING STAFFING IN BPCU • IMPLEMENT PLAN TO MAXIMIZE STAFF VS. NUMBER OF GARNISHMENTS MILESTONES/TIMING: • HIRE STAFF 12/11 • TRAIN STAFF AND INCREASE GARNISHMENT ACTIVITY 1ST QUARTER, 2012 • 2ND QUARTER, 2012 RESOURCE NEEDS: • ONE EMPLOYEE ASSIGNED TO TASK, WHICH INCREASED PRODUCTION BY 300% • WITH ADDITIONAL REQUESTED STAFF, WILL BE A SUBSTANTIAL INCREASE METRICS/MEASURABLE OUTCOMES: • INCREASE RECOUPMENT AND PREVENT REPEAT OFFENDERS DUE TO COURT ACTION

  8. PREVENTION OF BENEFIT YEAR EARNINGS KEY STRATEGIES: • SURVEILLANCE VENDORS UTILIZED TO PROVIDE SURVEILLANCE OF FRAUDULENT ACTIVITY, BOTH CLAIMANT AND EMPLOYER ACTION STEPS/DELIVERABLES: • JUNE, 2011 SURVEILLANCE CONTRACT APPROVED • REVIEW AND REFINE PROCESSES WITH VENDORS TO INCREASE ACCURACY IN CASES • IMPLEMENT BEST PRACTICES WITH VENDORS • INCREASE QUANTITY AND QUALITY OF CASES REFERRED TO VENDORS MILESTONES/TIMING: • 7/-9/11 • 10/11 • 11/12,2011 RESOURCE NEEDS: • INTERNAL: TWO BPC EMPLOYEES, ADJUDICATIONS AND TAX AUDITING • EXTERNAL: VENDOR AND OTHER STATE AGENCIES (REVENUE SERVICES, WORKER’S COMPENSATION, ETC.) METRICS/MEASURABLE OUTCOMES: • PREVENT APPROXIMATELY ONE MILLION UI OVERPAYMENT DOLLARS PER YEAR, AND IMPROVE PERCEPTION.

  9. AGENCY AWARENESS KEY STRATEGIES: • PROVIDE ALL DOL STAFF INFORMATION ON INTEGRITY ACTION STEPS/DELIVERABLES: • EDUCATIONAL/INFORMATION SESSIONS FOR UI STAFF • SESSIONS FOR EMPLOYMENT SERVICES AND ONE-STOP PARTNER STAFF • SESSIONS FOR APPEALS DIVISION STAFF • SESSIONS FOR FIELD AUDIT STAFF MILESTONES/TIMING: • 3RD QUARTER, 2011 • 3RD AND 4TH QUARTER, 2011 • 1ST QUARTER, 2012 • 2ND QUARTER • ONGOING RESOURCE NEEDS: • STAFF TIME AND RESOURCES METRICS/MEASURABLE OUTCOMES: • OVERPAYMENT PREVENTION: INFORMATION/EDUCATIONAL

  10. RECOUPMENT TOP AND SAFGUARD PROCEDURES REPORT KEY STRATEGIES: • IMPLEMENT TREASURY OFFSET PROGRAM ACTION STEPS/DELIVERABLES: • APPROVED SPR • COMPLETE PENDING SAFEGUARD TASKS • COMPLETE DESIGN AND DEVELOPMENT • BEGIN TESTING • IMPLEMENT OFFSETS MILESTONES/TIMING: • 2010 • SEPT., 2011 • NOV., 2011 • NOV., 2011 • FEB., 2012 RESOURCE NEEDS: • IT STAFF AND CONSULTANTS (UNTIL IMPLEMENTATION) METRICS/MEASURABLE OUTCOMES: • INCREASE RECOUPMENT OF NON-COMPLIANTFRAUD OVERPAYMENTS

  11. INTEGRITY SOFTWARE KEY STRATEGIES: • PURCHASE AND INSTALL INTEGRITY SOFTWARE ACTION STEPS/DELIVERABLES: • RFI • HIRE BUSINESS ANALYSIS • COMPLETE BUSINESS REQUIREMENTS AND SUBMIT “INVITATION TO BID” • HIRE VENDOR • DESIGN AND DEVELOPMENT TESTING • ANTICIPATED IMPLEMENTATION MILESTONES/TIMING: • JUNE, 2011 • JULY, 2011 • DECEMBER, 2011 • APRIL, 2012 • 2ND AND 3RD QUARTER, 2012 • 4TH QUARTER, 2012 RESOURCE NEEDS: • IT AND VENDOR STAFF METRICS/MEASURABLE OUTCOMES: • DETECT CLAIMANT FRAUD SCHEMES; DETECT EMPLOYER FRAUD SCHEMES

  12. KEY STRATEGIES: REDUCING QUARTERLY CROSSMATCH OVERPAYMENTS ACTION STEPS/DELIVERABLES: GENERATE A LIST OF POTENTIAL QUARTERLY CROSSMATCH OVERPAYMENTS SEND LIST TO MAINFRAME QUERY MAINFRAME FOR ACTIVE FILERS ON LIST GENERATE STOP AND MESSAGE ON ACTIVE FILERS CASE REVIEWED, PROCESSED AND REMOVED FROM BACKLOG REVIEW OUTCOME TO DETERMINE LONG TERM IMPLEMENTATION (CHANGE FROM QUARTERLY TO MONTHLY) MILESTONES/TIMING: JUNE 20, 2012 RESOURCE NEEDS: COMPLETED QUERY IN BOTS BY PBC IT STAFF CALL CENTER STAFF METRICS/MEASURABLE OUTCOMES: REDUCE ONGOING FRAUD OVERPAYMENTS DUE TO PENDING BACKLOG ROOT CAUSES

  13. KEY STRATEGIES: CLAIMANT COMMUNICATION AUDIT AND PLAN ACTION STEPS/DELIVERABLES: ESTABLISH MESSAGING WORK GROUP REVIEW OF CLAIMANT MESSAGING TOOL KIT AND MESSAGES REVIEW OF CURRENT MATERIALS, DETERMINE WHERE NEW MESSAGING MAY BE APPROPRIATE WORK GROUP DETERMINES LONG AND SHORT TARGET MESSAGING AND VEHICLES PRESENT PLAN FOR CLAIMANT MESSAGING MILESTONES/TIMING: OCTOBER, 2011 NOVEMBER, 2011 1ST QUARTER, 2012 2ND QUARTER, 2012 3RD QUARTER, 2012 RESOURCE NEEDS: UI AND COMMUNICATIONS STAFF. FUNDING TO ROLL OUT ANY NEW MATERIALS METRICS/MEASURABLE MEASURES: REDUCTION OF BYE IMPROPER PAYMENTS AS INDICATED IN BAM DATA BENEFIT YEAR EARNINGS

  14. OWNING INTEGRITY AND COMMUNICATION ISSUES KEY STRAGEGIES: • SHARE BAM ACROSS UI ACTION STEPS/DELIVERABLES: • BAM SUPERVISOR WILL PROVIDE INFORMATION ON IMPROPER PAYMENTS INCLUDING CAUSES AND SUGGESTED REMEDIES • BAM UNIT WILL PLAN AND DELIVER A PRESENTATION REVIEWING ROLE OF BAM AND MATERIAL DATA • BAM PRESENTATION/ROAD SHOW TO BE DELIVERED TO ALL UI UNITS • BAM SUPERVISOR TO MEET QUARTERLY WITH UI MANAGEMENT TEAM TO REVIEW BAM DATA AND SUGGEST TRAINING OPPORTUNITIES MILESTONES/TIMING: • 1ST QUARTER, 2012 • ON-GOING RESOURCE NEEDS: • STAFF TIME AND TRAVEL RESOURCES • TRAINING ASSISTANCE METRICS/MEASURABLE OUTCOMES: • IMPROVED AWARENESS AMONG STAFF REGARDING CAUSES AND PREVENTATIVE MEASURES OF IMPROPER PAYMENTS

  15. BENEFIT YEAR EARNINGS AND EVERYONE OWNS INTEGRITY KEY STRATEGIES: • UI PARTNERING WITH EMPLOYMENT SERVICES TO DELIVER INTEGRITY INFORMATION ACTION STEPS/DELIVERABLES: • REVIEW OF ENHANCED REEMPLOYMENT SERVICES PROGRAM (ERS) WITH HARTFORD ES STAFF • MAKE SUGGESTED CHANGES TO PROGRAM PRESENTATIONS • IMPLEMENT A PILOT WITH SUGGESTED CHANGES • POTENTIAL ROLL OUT TO OTHER OFFICES MILESTONES/TIMING: • 1ST QUARTER, 2012 REVIEW AND MAKE CHANGES • 2ND QUARTER, 2012 PILOT CHANGES METRICS/MEASURABLE OUTCOMES: • OVERPAYMENT PREVENTION AND AWARENESS, REDUCTION OF OVERPAYMENT CASES

  16. PREVENTION KEY STRATEGIES: • INCREASE ACCURACY OF SEPARATION INFORMATION ACTION STEPS/DELIVERABLES: • REVISIONS TO INITIAL LACK OF WORK VERIFICATION FORM – TO EMPLOYERS INCORPORATE VERIFICATION FOR PARTIAL UNEMPLOYMENT, TEMP. EMPLOYMENT, LACK OF WORK AND POTENTIAL REFUSALS OF REHIRE MILESTONES/TIMING: • FIRST DRAFT PREPARED NOVEMBER 30TH, 2011 • IT REVIEW 1ST QUARTER – IMPLEMENT 6-30-12 RESOURCE NEEDS: • ONCE FINALIZED, WILL NEED TO HAVE IT REPLACED IN TICS METRICS/MEASURABLE OUTCOMES: • DECEMBER, 2011 – IMPLEMENT JUNE, 2012

  17. COMMUNICATION AND PREVENTION KEY STRATEGIES: • DEVELOPING A UI INFORMATIONAL POSTER FOR EMPLOYERS TO ADVISE CLAIMANTS ON BASIC UI INFORMATION, OP INFORMATION AS WELL AS MARKET ES SERVICES ACTION STEPS/DELIVERABLES: • DEVELOP INFORMATION LIST • DEVELOP FORMAT • PRINT AND PUBLISH TO WEB MILESTONES/TIMING: • JUNE 30, 2012 RESOURCE NEEDS: • ELECTRONIC METRICS/MEASURABLE OUTCOMES: • UI INTEGRITY AWARENESS PREVENTION

  18. DEPENDENTS ALLOWANCE KEY STRATEGIES: • REDUCE IMPROPER DEPENDENCY ALLOWANCE PAYMENTS ACTION STEPS/DELIVERABLES: • CROSS MATCH ALL CSI (COURT ORDER) DEPENDENTS VS. DEPENDENT ON FILE VIA TIC RECORD • PILOT SAMPLE/REVIEW OF CLAIMANTS RECEIVING DEPENDANCY ALLOWANCE RESULTING IN POTENTIAL MISREPRESENTATION MILESTONES/TIMING: • JUNE, 2012 RESOURCE NEEDS: • ADDITIONAL RESOURCE ASSOCIATE METRICS/MEASURABLE OUTCOMES: • REDUCTION IN THE IMPROPER PAYMENT RATE • IMPROVEMENT TO FUND SOLVENCY

  19. BENEFIT YEAR EARNINGS KEY STRATEGIES: • CROSSMATCH WAGE COMPLAINTS FROM THE DEPARTMENT OF WAGE AND WORKPLACE STANDARDS FOR POTENTIAL UI FRAUD ACTION STEPS/DELIVERABLES: • SAMPLE REVIEW OF COMPLETED WAGE COMPLAINTS INVESTIGATIONS RESULTING IN POTENTIAL FRAUD OF UI • DETERMINE IF REGULAR CROSS MATCH WILL PREVENT FRAUDULENT CLAIMS • PRESENT OUTCOMES AND DETERMINE IF VIABLE MILESTONES/TIMING: • 2ND AND 3RD QUARTER, 2012 RESOURCE NEEDS: • WAGE AND HOUR DIVISION METRICS/MEASURABLE OUTCOMES: • DETECTING FRAUDULENT OVERPAYMENTS

  20. DETERRENTS KEY STRATEGIES: • LAW REGULATION CHANGES ACTION STEPS/DELIVERABLES: • RECOMMEND POTENTIAL CHANGES IN OVERPAYMENT LAWS AND REGULATIONS SPECIFICALLY PERTAINING TO PENATLIES WITH THE GOAL OF DETERRING CLAIMANT AND EMPLOYER CONDUCT LEADING TO IMPROPER PAYMENTS • REVIEW/MODIFY AND RECOMMEND POTENTIAL CHANGES IN LAWS AND REGULATIONS PERTAINING TO WAIVERS MILESTONES/TIMING: • 1ST AND 2ND QUARTER, 2012 • NEXT SCHEDULED LEGISLATIVE SESSION • 3RD AND 4TH QUARTER, 2012 RESOURCE NEEDS: • ADMINISTRATIVE AND LEGISLATIVE SUPPORT TO RECOMMENDED CHANGES METRICS/MEASURABLE OUTCOMES: • REDUCTION IN FRAUDULENT CLAIM FILING

  21. *****KILLER APP:***** DESCRIPTION OF ISSUE: • CLAIMANTS FAILING TO REPORT EARNINGS AND/OR RETURN TO WORK IN A TIMELY AND ACCURATE MANNER DESCRIPTION OF SOLUTION: • EMAIL (WITH A LINK TO AN INFORMATIONAL WEBINAR) FOR NEW CLAIMANTS AND/OR NEW CLAIMANTS REPORTING PARTIAL CLAIMS AND/OR CLAIMANTS WITH A DOCUMENTED RETURN TO WORK DATE REPORTED ON THE NATIONAL DIRECTORY OF NEW HIRES ANTICIPATED RESULTS: • ASSIST IN MEETING THE REQUIRED PERFORMANCE MEASURES • TIMEFRAME JULY/AUGUST, 2012 COST BENEFIT: • MORE TIMELY INTERVENTION INTENDED TO PREVENT AND/OR REDUCE OVERPAYMENT BY AN INCREASED ACCURACY IN CLAIMANT REPORTING USING AN AUTOMATED SYSTEM WHICH REQUIRES MINIMAL STAFF INTERACTION

More Related