Benefits 24/7 stabilization update - week of March 17-21

Washington State Health Care Authority sent this bulletin at 03/21/2025 04:12 PM PDT

3.21.2025

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

B24/7 Reports Workgroup. We have set up a workgroup including PEBB and SEBB benefits administrators and HCA’s Outreach and Training and Benefits 24/7 staff to review Benefits 24/7 report requirements. The purpose is to collect feedback to improve the functionality and accuracy of these reports.

Updates on previously reported priorities

Resolving errors between Benefits 24/7 and Pay1. HCA’s Pay1 team has been working to reduce errors that stem from the sync file between Benefits 24/7 and Pay1. These sync errors cause account transactions to not update correctly in Pay1.

Issues that have been addressed

Incorrect UMP Classic Medicare enrollment. Some retiree accounts were incorrectly placed in UMP Classic Medicare with Part D (PDP) coverage. This caused these subscribers to be denied enrollment in other health coverage when their UMP coverage with Moda (UMP’s pharmacy benefits administrator) has not yet been terminated. HCA worked with Moda to identify these subscribers and process their accounts before they are terminated from their other coverage. HCA also created a process with Moda to expedite the retirees’ plan termination to avoid delays in new Medicare plan enrollments.

Premium discrepancies. HCA resolved the remaining premium discrepancies for some PEBB retiree accounts in which the wrong premiums were being charged.

Blank medical plan code when no enrollment exists. If an employee selected coverage during their new enrollment window, and then later waived that coverage while still in the new enrollment window, the system sent the wrong information to Pay1, resulting in the coverage not getting waived. The implemented fix ensures that the proper information is sent when coverage is waived.

Sync file sending updated marital status for SOE that wasn't approved. When a special open enrollment (SOE) is created for adding a spouse, the marriage date was being sent to Pay1, even if the SOE wasn’t verified. A fix was deployed to not send the marriage date unless and until the SOE and spouse have been verified.

Data fix for extended dependent verification. Pay1 contained a handful of legacy verification status for extended dependents which were not in the Benefits 24/7 database at the time of migration. This caused these values to be dropped during migration. Values were updated on the identified accounts.

Dependents with relationship end dates and active enrollments. Dependents with ended relationships were found still enrolled in the system. This affected 1,997 dependents, primarily SEBB. These were identified and adjusted without any impact to billing.

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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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.