Eexchange Client Questionnaire

eExchange Client Questionnaire

Client Name
Carrier Account Manager
Call Date

Contact Information

Main HR Contact / Main BCBSNC Contact / Main Technical Contact (Vendor)
Name
Title
Phone
Email
Benefitfocus Technical Contact / Reporting Contact
Name
Title
Phone
Email

Initial Setup and Plan Information

File Format / Data Transmission
834 5010 / SFTP / VPN/FTP
Simple File Format / FTP/PGP / Other:
FTP Information Assigned / Effective Dates
Login: / Renewal Period Dates
Password:
Will BCBSNC’s Group/Basic information (see profile document) be on the file?
If no, explain how to map

Will the following information be on the file?

COBRA participants / Foreign addresses
Retiree information / Handicap indicator
Part-time employees / Hire/rehire dates
Employee Social Security Number Changes
Will you be able capturetheemployee’s social security number on your file?

Will you be able to capture dependent social security numbers on your file?

Employee Phone Number Changes

Will you be able to send employee phone number on your file?

Will you be able to send employee email addresses?

Change File Process

File Frequency / Day / Time / File Type
Weekly / Full files (all contracts)
Twice weekly
Other:
Once in production, when should a file be considered late? / 24 Hours
BCBSNC Plan Set Up Information
Medical / Split contracts
Dental / Cobra administered by BCBSNC?
Allow domestic partners
If Split Contracts are allowed:
Can spouses continue with benefits when an employee/retiree dies?
If yes, will you be able to identify them as such on your file?

Validations and Business Rules

Term Date
End of the month
Date of event
Other:
Retro term rule:
BCBSNCCoverage Termination Info on File / End Dates for BCBSNC Coverage
Employees / Last day of coverage
Dependents / First day without coverage
Will terminated people be dropped off the next file following the terminationtransaction?
If no, when?
Effective Date Rules
First of the month
Date of event-pass any effective date on the file
If first of the month, should the contract error if it violates the start date rule (i.e., for a qualifying life event)? Or should any effective date be passed on the file to the carrier?

Will you send newborns on the file with their date of birth equal to the effective date?

Additional Effective Date Validations-Will client be able to send updated effective dates for:
Group number changes (if more than one group number)
Plan changes (benefit package changes)
Coverage level changes
Will effective dates need to be rolled forward?

Optional Validation and Business Rules

Missing Employees - If an employee drops off the file without first being sent as a termination, what action should be taken?
Send the entire contract to the exception report to review
Term the contract by omission(please specify what date should be used)
Missing Dependents-If a dependent drops off the file without first being sent as a termination, what action should be taken?
Send the entire contract to the exception report for review
Term the contract by omission(please specify what date should be used)
Overage Dependents-If a child sent on the file is over the maximum dependent age and is not handicapped, what action should be taken?
Send the contract to the exception report for review
Send the dependent normally
Term the dependent (please specify what date should be used)

Additional Information

Please list any additional business rules below:
Please list any Annual Enrollment processing that differs (e.g. terms dropping off, new effective dates, etc):

A separate Open Enrollment call will be held a few months prior to renewal to discuss how the Open Enrollment file will be handled

Timeline

Approximate date of first test file
Approximate date of second test file with testing scenarios
Approximate date of first production file