1 / 11

Washington HBE Shop Enrollment Guidelines and Workshop Schedule

Get detailed guidelines for Shop enrollment processes along with information on Washington Health Benefit Exchange's upcoming Carrier Workshops. Email Brad Finnegan to schedule a workshop.

michaeljacobs
Download Presentation

Washington HBE Shop Enrollment Guidelines and Workshop Schedule

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. Scenarios: SHOP Enrollments February 14, 2013 1:00-3:00 PM

  2. Agenda

  3. WA HBE Technical Meeting Schedule

  4. SHOP Initial Enrollment Timeline

  5. SHOP Ongoing Enrollment Timeline

  6. General SHOP 834 Guidelines • Initial enrollment – 834 changes sent after cutoff along with 834 audit • Ongoing enrollment – 834 changes sent daily, 834 audit sent monthly • Each Issuer will have separate folders, within this there will be a Test and Prod folder • Inbound - Used to drop the inbound files that need to be submitted to the Exchange (820 if Issuer receives payment directly) • Ack - Trading partner should look for acknowledgements to the files submitted in this folder. 999 and custom error reports will be available for all the files submitted by the Trading Partner • Outbound – outbound transactions generated by the Exchange will be available in this folder (834 and 820 files) • Error – Any inbound file that is not ASC X12 compliant or is not recognized by the Exchange will be moved to this folder

  7. Folder Structure

  8. General SHOP 834 Guidelines • The files are named such that the Individual Market and the SHOP Market are separate files and thus don’t need separate folders. • <TPId>.<market>.<QHPId>.<datetimestamp>.<TxID><Frequency>.<O> • Example of file name: 165760000.I.1234.12262012211315.834.M.O • When acknowledgements are produced, append an “A” on the end of the file so we know which file was acknowledged • It has been suggested that if we do not have data that we produce an empty file so Issuers know our process ran

  9. General SHOP 834 Guidelines • Enrollment is sent at QHP/Plan level • Within each enrollment, we send employer, employee, dependent information • ISA • GS for QHP • ST for each enrollment • 1000A – Sponsor Name (Employer Name) • 1000B – Payer (Issuer Name) • 2000 – Member Level Detail (For each employee and dependents) • 2100A – Member Name • 2100C – Member Mailing Address • 2100D – Member Employer • 2300 – Health Coverage • 2700/2750 – Reporting Categories • SE • GE • IEA

  10. REMINDER: Carrier Workshops Washington Health Benefit Exchange will be hosting Individual Carrier Workshops. • The purpose of these Workshops is to provide continued support of Exchange implementation for Carriers by providing a setting to discuss impacts and changes specific to each carrier. SCHEDULE: Workshops will be held every Monday from 12:00pm – 2:00pm WHERE: HBE Olympia- 521 Capitol Way S Olympia, WA 98501 or Webinar hosted. HOW TO SCHEDULE A WORKSHOP: Please email Brad Finnegan at Brad.Finnegan@wahbexchange.orgwith a preferred date and a list of expected attendees.

More Related