Reconciliation of Benefit Data Updates in HRS

Overview

Overview of the steps taken to update HRS upon identification of benefit enrollment mismatches that may result in a financial reconciliation to collect/refund premiums to employees, triggered by the Reconciliation Team (Recon), Benefit Enrollment Recovery Team (BERT), Campus, or Vendors.

Process Considerations:

The following are typical enrollment issues identified:

State Group Health

Invoice Load Mismatches:

  • Plan: differences between plans elected in each system
  • Program: differences in programs Grad or Reg (WRS)
  • Coverage: differences in the coverage levels (Single/Family)
  • Enrollment: differences in the enrollments (Active/Not Active)
Reconciliation Process Mismatches: State Group Life
  • Premium deducted from employee Securian does not have covered: untimely app, SSN incorrect, WRS entry is missing, no application received, prior period adjustment from missed premium
  • Premium not deducted, Securian has active: LOA, missed payroll, terminated, refund for prior period over payment
  • Premiums not what expected: ABBR differences, enrolled in different coverage
Dental and Vision 
  • Premium deducted from employee but not covered at vendor: timing of enrollment file to invoice (held for one month before sending to Benefits to investigate and take corrective action
  • Premium not deducted from employee but covered at vendor: LOA, missed payroll, terminated, refund for prior period over deduction
  • Premium deducted from employee and invoiced different:Coverage enrollments do not match, wait one billing cycle and send to Benefits to investigate and take corrective action
  • All Other Plans
    • Reinstatements into wrong plan or coverage
    • Requested a refund from the vendor, due to an erroneous waive row
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    Instructions

    Benefit Enrollment errors occur when the data entered into HRS does not match the data entered into the vendors system. These data discrepancies are discovered in various ways depending on the benefit plan. In most situations the steps to correct are similar:
    1. Data error is identified by Recon, BERT Campus, or Vendor.
    2. UWSC Benefits is notified of the issue through a Recon report (ETF Term List), WISCIT, or email.
    3. UWSC Benefits contacts the campus to determine the correct data.
    4. UWSC Benefits uses ADM (Administrative) Event to correct HRS.  If the ADM cannot fix the issue, they use Correct History (last resort) or works with the vendor to correct their system.
    5. If the data error created a financial impact, UWSC Benefits creates a ticket, if not previously created, and assigns to BERT or Madison Benefit Services for any financial corrections.

    In a few situations the Benefit Enrollments are correct, however the Benefit Reconciliation Table shows variances due to Benefits Program Participation (BPP). Many times the BPP cannot be updated to reflect what the employee paid:

    Grad - Reg Changes 

    Full-Part Time


    Additional Resources

    Related KBs:

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