Benefits 24/7 stabilization update - week of March 10-14

Washington State Health Care Authority sent this bulletin at 03/14/2025 03:30 PM PDT

3.14.2025

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

2024 LTD rates showing for some accounts. For some accounts, the long-term disability (LTD) insurance rates displayed in Benefits 24/7 show the 2024 rates. HCA confirmed this affects only the rate table shown on the Supplemental Benefits tab in Benefits 24/7; the rates in the billing files are showing 2025 rates.

Dependent becoming a subscriber. When a dependent becomes a subscriber under the same program and selects their own medical plan, Benefits 24/7 is sending incorrect start and end dates to Pay1 for the original medical, dental, and/or vision plans.

Updates on previously reported priorities

Resolving discrepancies between Benefits 24/7 and Pay1. Using the recently updated Discrepancy Reports, the Outreach and Training team has been working to resolve these discrepancies between the Benefits 24/7 and Pay1 systems.

Reviewing ticket backlogs. All teams have been reviewing their ticket backlogs to identify duplicate tickets and clean up ticket queues to help ensure we have an accurate understanding of the number of tickets and who owns them.

Members not seeing their SmartHealth wellness incentive. Some Kaiser Permanente WA (KPWA) members were not seeing their SmartHealth wellness incentive applied to their 2025 deductible. HCA confirmed this only affected KPWA accounts and that KPWA has since applied the SmartHealth wellness incentive to those affected accounts. HCA is now reviewing just over 100 PEBB and SEBB accounts in which their SmartHealth wellness indicators show discrepancies between Benefits 24/7 and Pay1.

Issues that have been addressed

Earlier identified issues that were addressed this week:

Restoring special open enrollment dates. As a result of a fix from an earlier issue, when verifying special open enrollments with a future coverage start date, the most recent enrollment was being deleted. HCA restored the enrollments for the 44 affected PEBB and SEBB accounts and resolved the issue to prevent the enrollments from being deleted.

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.

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