HR453 Ability to Calculate and Store Workers Comp Rate

State of Connecticut

Core-CT Project

Application:HRMS

Module:Human Resources

Business Process:Monitor Health & Safety/Workers Compensation

Requirement Number:HR453

Requirement Title:Ability for system to maintain information pertaining to and calculate the Workers’ Compensation Rate

Module Leads: Lina Simonu, Lisa Lagus

1. Requirement Description

Describe the requirement (gap). Include a description of the delivered PeopleSoft functionality.

The State of Connecticut currently has the ability to calculate and maintain information pertaining to the Workers’ Compensation rate. The Worker’s Compensation rate is based on the following: 1) Type of claim rate (66 2/3%, 75%, 80% or 100%), 2) the average of the previous 52 weeks salary as of the claim date for in State and out of State jobs that may be held by the employee, and 3) Worker’s Compensation Filing Status and Withholdings. In addition, a rate table exists that identifies the worker’s compensation rate based on a combination of the three variables. The rate table is effective dated. The Worker’s Compensation rate is not paid to the employee from the current AWCS system. The Third Party also calculates the rate based on the aforementioned information. The calculation of the rate by the State of Connecticut is for auditing purposes. PeopleSoft, as delivered, does not have the ability to determine the Worker’s Compensation Rate, nor does it store 1) the type of claim rate, 2) the average of the previous 52 weeks salary as of the claim date for out of State jobs that may be held by the employee, or the 3) Worker’s Compensation Filing Status and Withholdings. PeopleSoft also does not deliver a worker’s comp rate table.

1. Business Need

Provide a justification for the requirement. Include information about frequency, volume, number of users impacted, etc.

The current system has an automated process to maintain information required to calculate and calculate the Worker’s Compensation benefit rate for auditing purposes. This enables the State Internal Audit department to identify issues of over or under payments. The benefit rate may be also be used by the Agency HR or Payroll Specialist in reconciliation of the first check from the TPA to the Agency. There are approximately 3,000 agency first checks produced annually statewide. The State also changes TPA’s from time to time, by ensuring the calculation and maintenance of information exists in PeopleSoft this transition may occur more smoothly. State Statute 5-142

1. Required By: (Y/N)

Federal ____Agency __Y__Bargaining Unit __

State Statutory _Y___State Regulatory ____State Procedural __Y__

1. Requirement Priority

Medium_(High, Medium, Low – please see “Requirements Prioritization Criteria”)

1. Recommended Solution

Enter an “X” next to the appropriate category

_____ Process Solution

__Option Number

__X___Application Modification

_1_Option Number

1. Explanation for Recommendation

Provide reasons for recommendation. Please do not re-state the description of the solution itself.

The State’s current Worker’s Compensation system maintains all of this information for auditing purposes. With the recommended option, this information could be maintained and calculated in PeopleSoft. This will ensure that verification of rate calculation occurs for every worker’s compensation claim, not just on a periodic basis. This is a concern for the Central State of Connecticut Worker’s Compensation department, as previous TPA’s have not been successful at consistently calculating the correct rate. This creates issues and liabilities for the State of Connecticut.

1. Organizational Impact of Recommendation

Describe the changes to the organization that result from the recommended solution. Include a description of any role, process, statute, or bargaining unit agreement affected.

The Agency HR Specialists would need to have enter the Filing Status and update the average calculated 52 weeks salary information with out of state salary information if necessary. This is not a change in their current process.

1. Process Solutions

Describe the possible Process Solutions. Include a description of impacts and benefits of each solution.

Option 1. The TPA could maintain all of the information required to calculate the Worker’s Compensation rate in their system. The type of claim is determined by the TPA, therefore, they have this information upon claim settlement. PeopleSoft would maintain the prior 52 weeks salary information and provide the average calculated rate as of the claim date, see requirement #HR462. The out of State salary information is currently manually obtained from the employee and the information could be forwarded to the TPA. Finally, the Agency HR Specialist would obtain the Worker’s Compensation Filing Status and Withholdings from the employee using the Filing Status and Exemption Form (1A) and forward the form to the TPA. Note: All agencies will have access to view this information on the TPA system. It was previously believed that only the large agencies would have access, however, all agencies have been granted access. This would allow them to audit random claims to ensure the rate calculation is accurate.

1. Application Modifications

Describe the possible Application Modifications. Include a description of impacts and benefits of each solution.

Option 1.

Modification Type (On-line, Batch, Interface, Report, Workflow): On-line/ Batch

Complexity (Easy, Medium, Difficult): Difficult/ Difficult

Description: Create a new record, and page to store worker’s compensation rate information. Add fields to store 1) the type of claim rate, 2) the average of the previous 52 weeks salary as of the claim date for in and out of State jobs that may be held by the employee, and 3) the Worker’s Compensation Filing Status and Withholdings. Also, a new Worker’s Compensation rate field would be required so that the Agency would be aware of the daily rate paid to the employee by the TPA. This record would need to be effective dated to handle multiple Worker’s Compensation rates, as employee’s may have annual increases while they are on Worker’s Comp and would be eligible for a higher rate of pay. The type of claim rate would continue to be determined by the TPA following the settlement and provided to the State of Connecticut for entry. Average State of Connecticut salary information would be calculated and updated through a batch program, based on the last 52 weeks salary as of the claim date, see Requirement #HR452. Out of State salary information would need to be determined outside of the system and manually entered by the Agency HR Specialist. Tax information will continue to be obtained and recorded using the Filing Status and Exemption Form (1A) into the new page and record by the Agency HR Specialist. This information would be sent through the custom PeopleSoft to TPA interface, see Requirement #HR452, so that the TPA may also calculate the appropriate benefit rate.

A custom rate table and page also needs to be created to store the worker’s compensation benefit rates so that the State of Connecticut may calculate the benefit rate. This table must be effective dated to maintain history. Legacy rates need to be converted to ensure claims filed in the future or re-occurrances based on previous incidents receive the correct rate based on effective date.

A custom batch program would need to be created to run on a periodic basis to derive the benefit rate. The derivation of the daily rate is through a combination of the 1) the type of claim rate, 2) the average of the previous 52 weeks salary as of the claim date for in and out of State jobs that may be held by the employee, and 3) the Worker’s Compensation Filing Status and Withholdings. The program would determine based on these values, the corresponding benefit rate found on the custom rate table and update the custom worker’s compensation rate field.

Note: For this option, the Worker’s Compensation rate is calculated by PeopleSoft, but not sent to the TPA. The State of Connecticut requires the TPA to also calculate the rate to ensure accuracy.

Option 2.

Modification Type (On-line, Batch, Interface, Report, Workflow): On-line/ Batch

Complexity (Easy, Medium, Difficult): Medium/Medium

Description: Create a new record, and page to store worker’s compensation rate information. Add fields to store 1) the type of claim rate, 2) the average of the previous 52 weeks salary as of the claim date for in and out of State jobs that may be held by the employee, and 3) the Worker’s Compensation Filing Status and Withholdings. Also, a new Worker’s Compensation rate field would be required so that the Agency would be aware of the daily rate paid to the employee by the TPA. This record would need to be effective dated to handle multiple Worker’s Compensation rates, as employee’s may have annual increases while they are on Worker’s Comp and would be eligible for a higher rate of pay. The type of claim rate would continue to be determined by the TPA following the settlement and provided to the State of Connecticut for entry. Average State of Connecticut salary information would be calculated and updated through a batch program, based on the last 52 weeks salary as of the claim date, see Requirement #HR452. Out of State salary information would need to be determined outside of the system and manually entered by the Agency HR Specialist. Tax information will continue to be obtained and recorded using the Filing Status and Exemption Form (1A) into the new page and record by the Agency HR Specialist. This information would be sent through the custom PeopleSoft to TPA interface, see Requirement #HR452, so that the TPA may calculate the appropriate benefit rate.

Note: For this option, PeopleSoft would NOT be responsible for calculating the benefit daily rate, just providing the information to the TPA to calculate the rate. The State would also have the ability to periodically audit the TPA’s calculation by using the 3 values and verifying the rate derived from the rate table is the same as the TPA’s rate.

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