Department of Civil Service

PE08-34

TO: Participating Employer Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: Retroactive Transaction Processing
DATE: December 5, 2008

The purpose of this memo is to inform you of a policy change with regard to the processing of certain retroactive transactions in the New York State Health Insurance Program (NYSHIP) enrollment system known as NYBEAS. This policy change was previously announced at the annual Participating Employer Regional meetings held in November.

Beginning with transactions affecting the January 2009 billing, there will be a maximum six-month retroactivity period. Certain transactions with an effective date greater then six months from the date processed will result in the following error message and you will not be able to save the transaction:

“This transaction exceeds the six-month retroactivity limit, please contact EBD to process.” 

For example, if a transaction, which affects billing, is processed in December 2008, the effective date of the change can be no earlier than July 1, 2008. Please note: This retroactivity limit applies to premium credits AND charges. The following transactions are subject to the retroactivity limit:

• Termination
• Deceased
• Enrollment
• Medicare
• Cancellation
• Change of Coverage
• Dependent Delete (where the person being deleted has Medicare)

To assist agencies in maintaining compliance with this change, EBD will continue to provide each agency with a quarterly reconciliation of covered employees and dependents. Please review your reconciliation listings and process needed transactions in a timely manner. EBD will also continue to produce and mail the annual Enrollee Benefit Statements, notifying your enrollees of their current benefits/coverage level.

Any questions regarding this change in policy can be directed to the Participating Employer Processing Unit at (518) 474-2780 or the Public Employers Liaison Unit at (518) 485-1771.