Has anyone devised a creative way to send COBRA paid through dates in the
834? �You have Member Level Dates in the 2000 Loop for COBRA Begin and End,
but I'm interpreting these as "effective", which may be different than the
acutal "paid" dates.
There was a DSMO request to add a code in INS04 for "Non-Payment" (text
below) , though it doesn't appear this request made the addenda. �But this
seems to indicate others need to communicate the payment status for COBRA.
Any ideas?
Thanks for your feedback.
Freida Hall
CGE&Y
###
DSMO Request:
Business Reason
Health New England (HNE) and Massachussetts Business Association (MBA) are
doing a pilot of the 834 Enrollment Transaction.� MBA services our small
employer groups (1-5 eligibiles). They enroll the subscribers and
dependents in their system, then send an 834 to HNE for entry to our
system. MBA is responsible for premium billing and collection.
The INS04 element "Maintenance Reason Code" in the 2000 loop "Member Level"
of the 834 carries the reason for termination. One of the reasons to
terminate a family is non-payment of premium. This can be at the employer
level (all subscriber's under an employer are teminated) or at the family
level (such as a COBRA premium). The current implementation guide does not
have a code for this reason.
Suggested Change
Please add the X12 standard code 59 "Non-Payment" to the implementation
guide, page 43, INS segment INS04 element. Data element 1203.
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