Primary Care Provider information needed in 834 report





Description of Issue

Need to include employee's Primary Care Provider's information in the 834 Report.



Context
  • Employee Benefits 834 Export

  • 834 Report

  • Open Enrollment



Cause

Health Insurance Provider requires the Primary Care Provider's information to be submitted with the 834 report.

In the Open Enrollment process, the employees can enter the Provider's information in the Value field in ESS. (This functionality must be setup in the Enrollment Choices program with the Required Input and Input Message fields.)

If the values are entered in Open Enrollment, they will be stored in the Value field of Employee Benefits Enrollment.



Resolution
  1. Navigate to Employee Benefit 834 Export.

    • Human Capital Management > Human Resources > Benefits Administration > Benefits Enrollment > Employee Benefits 834 Export

  2. Click 834 Report from the toolbar.

  3. If necessary, select the correct Employee Benefits 834 Report record, there may be more than one. Use the left and right arrows at the bottom of the screen to select the correct one.

  4. In the 834 Export program, select the NM1 - Provider Name found under the 2310 Provider Information loop.

  5. Click Update and select the 'Include Segment' check box on the right.

  6. Click Accept.

  7. Next, select NM109 Provide Identifier from the Element list and click the Pencil and piece of paper button to edit that element.

  8. In the Segment Element Definition Section, select Crosswalk as the Type.

  9. In the Crosswalk Definition Entry screen use the following.

    1. Crosswalk Table: Benefit Elections (pmbnelec).

    2. Section: whichever section the provider is being entered for  (example: HLTH, DENT, LIFE, etc.).

    3. Year: the Open Enrollment Year.

    4. Proj: Projection Number Used (RPT_Proj).

    5. Employee Id: Subscriber's ID Number (pmbf_emp).

    6. Crosswalked Value: Value.

    7. NOTFound Action: Original Value when NotFound.

    8. Click Accept to save the Crosswalk Definition.

  10. Click Accept to save the record.



Additional Information

Please review the Master Article - 834 Reporting for all related topics.