Benefits 24/7 stabilization update - week of March 3-7

Washington State Health Care Authority sent this bulletin at 03/07/2025 02:45 PM PST

3.7.2025

Dear Benefits Administrators,

Here are updates on HCA’s priorities and progress to stabilize the Benefits 24/7 platform for PEBB and SEBB employees. Our intention is to keep you informed on identified issues, how we’re prioritizing them, and when they’re addressed.

This list does not include all the identified issues, but several that we are prioritizing based on their impact on members’ enrollment. Keep in mind that we’re balancing the work on these issues with additional system issues affecting other PEBB and SEBB members, including retirees.

New priorities

Long-Term fix for missing premium pension deductions. HCA implemented a short-term fix for DRS identified accounts where the pension deduction for December's UMP premium was removed. HCA is now working on a permanent fix.

Members inadvertently terminated from EyeMed Vision coverage. EyeMed noticed that some members were left off a monthly file from HCA. This omission could have resulted in their coverage being erroneously terminated. HCA is reviewing.

Ensuring member IDs are assigned accurately. There are several hundred cases where a member has either been assigned multiple IDs within a single program or where the member needs a second ID assigned when moving to another program. Resolving these member ID issues will help improve data accuracy in the system and reports and help ensure updates are being applied to the correct member record.

Updates on previously reported priorities

Enrollment data for 836 individuals erroneously left off the December 24 carrier eligibility files. HCA has now sent data to the carriers for 735 individuals who were inadvertently left off these eligibility files. There are 101 individuals remaining whose enrollment did not reach the carriers from the December 24 file that are being analyzed for submission.

Issues that have been addressed

HCA had earlier identified issues that were addressed this week:

Adding newborns during special open enrollment (SOE). Making a plan change during SOE along with adding a newborn/adopted child was resulting in many newborns/adopted children not being added to coverage. This was addressed to correctly enroll the newborn/adopted child when a medical plan change also occurred as part of the SOE.

Benefits 24/7 wizards aged out dependents before age 26. The Benefits 24/7 open enrollment and SOE wizards were considering dependents aged out of benefit eligibility if their 26th birthday was within 30 days of the coverage start date. This was addressed and additional clarifying language was added to the wizard.

HCA’s daily eligibility files to MetLife Vision were erroring out. While performing testing on updates to the Benefits 24/7 system framework, the HCA’s daily eligibility files to MetLife Vision were erroring out. While there were no account issues that occurred, issues would have resulted in production had this not been fixed.

Dependent SOEs. When an SOE was created and a dependent added, it created a 2nd SOE with an earlier date that was causing issues. HCA implemented a solution to update relationship start dates when an SOE creates an earlier enrollment for a dependent and to not create duplicate enrollments from multiple SOEs with earlier dates.

Eligibility file issue for all vision plans. MetLife Vision reported they had issues enrolling members from some eligibility files. HCA determined this issue impacted some higher ed members and included plans from Davis Vision by MetLife and EyeMed Vision. This was addressed this week.

If you continue to have challenges on an issue that has been addressed, please submit a new ticket to HCA’s Outreach & Training team.

You can access weekly updates on the Benefits Administrator website via the pink alert box and under Notices and updates.

We appreciate your patience and understanding as we diligently work on resolving these and other issues.

About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

Disclosure notice

All messages we send via GovDelivery are subject to public disclosure, as are the names and email addresses of those who sign up for email notifications.

Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.