Membership and Contribution Administration System

SSI's Membership and Contribution Administration System (CAS) is capable of handling all the needs of a fund administrator for single or multi-employer plans. SSI's CAS System can create a bill for contributions payable and accommodates contributions received for as many different Funds as are covered under a CBA, tracking contractual work units, whether earnings, hours or other units worked by members, posts contributions made by employers, allows for self-payment by members, automatically determines eligibility, and produces various descriptive and analytical reports. Information can also be extracted for HIPAA compliant data interchange requirements. In addition to the many reports available as part of the system, unlimited reports can be generated through MS Access, Crystal Reports or any standard SQL based reporting function. If the client has an integrated imaging system, there will be easy links throughout the system to retrieve relevant documents, e.g., in the HIPAA authorization screen there would be a link to the authorization form submitted to the Fund.

EMPLOYER DATABASE

• Employer ID user or system generated and Federal tax ID number

• Multiple employer names to accommodate business name changes or mergers

• Employers can be linked to other controlling entities

• Multiple addresses and unlimited contact information, including different contact names and roles, phone, fax or cell numbers, e-mail addresses

• Funds to which the employer contributes based on the CBA

• Original Fund Dates and Fund Termination Dates for each Fund

• Employer groupings for reporting purposes

• Option to send remittance billing statement by employer

• History of CBA information, including benefit and contribution exclusions

• Unlimited free-form notes and comments

• Bond/Escrow information

• “Events” tracking all types of interactions with the employer with associated notes

• Documents tracking for all documents received by the Union or Fund Office, with optional direct link to the image of the document

• User-defined fields incorporated without custom programming

CONTRACTS AND RATES
This function is used to specify the rates at which an employer is obligated to contribute to each Fund.

• Rates can be specified by Hour, Day, Week, Month, Percent of Gross Earnings or Straight Earnings, or by Double or Overtime Hours.

• Rates can be different for each employer.

• Rates may be set for a specific entity such as a local.

• Rate Groups may govern rates for a category of employers or be tied to the side-letter to a contract.

• Special rates can be based on category of employment or work status, or based upon an individual’s benefit level. In addition, multiple rates can be established for the same Fund for the same contract period so that the amount due would be calculated by adding together the separately computed amounts. Minimum and maximum amounts can also be specified for any rate.

The processing of work history will automatically select the appropriate rates for the contribution period, allowing for easy posting, editing and reconciliation by the Fund.

 

MEMBER AND PARTICIPANT DATABASE
This is the core component of our systems. It represents a starting point for locating any information about a member or participant and all associated dependents. It has a tabbed approach to retrieving different elements associated with the member or participant. It also has easy to use context switching that gives the user the ability to go directly to the person’s records in claims history display or defined contribution and other areas without navigating through menus or re-keying the member’s social security or ID number.

Demographics:

• Member social security number and a separate participant ID as an alternative

• Name, with a history of name changes or stage names, and multiple addresses

• Addresses can be indicated as foreign, with the country name, or as a bad address

• Unlimited additional contact information including phone, fax or cell numbers, or e-mail addresses

• Previous Social Security number if there has been a change

• Sex, Date of birth (converted to present age or flagged as deceased), date of death, marital status (with full support of domestic partnership)

• User-defined fields incorporated without custom programming

Employment and Status History:
Members can be linked to a particular employer with a hire date and ultimately a termination date with a reason. The employer can be identified as a primary or secondary employer and the user can store department and title information if desired. A full history of these links is maintained with the most recent associations displayed first.
Various status codes can also be associated with a member with start and end dates. These user defined codes can be used in various ways, whether it is related to the type of worker (apprentice level, journeyman, gaffer, understudy), or current work status (newly organized, new hire, active, retired, disabled), or status within the union (shop steward, probationary, suspended, good standing) or for a combination of different purposes. The user id and date of entry or change is displayed for each of these entries.

 

Spouses and Domestic Partners:
 

• Up to 9 spouses or domestic partners, (with only one active at any one time)

• Name, SSN, Sex, Date of Birth, Date of Marriage (or Affidavit Date), Date of Death or Date of Divorce

• Effective and Termination date of the spouse for eligibility purposes

• Other insurance indicators (COB information)

• Employer name and address if available

• COBRA Status where applicable with the paid through date

• Alternate address to comply with HIPAA Privacy rules.

Dependents

• Up to 23 dependents for each member, in addition to the spouses or domestic partners

• Name, Social Security Number, Sex, Date of Birth, Date of Death

• Effective and Termination date for the dependent (dependents are pre-terminated based upon the plan rules for what is over-age)

• Date of Permanent Disability

• Student Status (the date of sending a certification letter and the date of receipt of proof), School name and address if available

• COBRA status where applicable with paid through date

• Alternate address to comply with HIPAA Privacy rules.

Beneficiary Information

• Name and address

• Relationship to member

• Effective and Drop Dates as beneficiaries

• Benefit(s) for which this person is the beneficiary

• Indication of primary, secondary or tertiary beneficiary

• Benefits assigns either by percentages of the total benefit or a fixed amount

Eligibility and Coverage History

• Complete history of coverage for each benefit or group of benefits

• Plan, Carrier

• Coverage effective date and termination or suspension date

• Coverage information fully integrated with the claims payment systems and is the basis for HIPAA compliant file exports

A custom function is developed for each client that automatically determines eligibility by evaluating work history or employer contributions based upon the plan’s eligibility rules. The program would review any relevant work units, with multiple look back periods where applicable, and recognize any other eligibility credits that may have been accumulated. The program accommodates any rules that exist for initial eligibility, continued eligibility or reinstatements, and the calculations can result in different coverage levels for each participant based upon the employer group or the amount of eligibility credit earned by the member. A report is created to show all changes to coverage, with the before and after coverage information for staff review. The eligibility changes can automatically be posted to the participant database, or staff. with an appropriate security level, can adjust the results of the calculation program.

 

Coordination of Benefits (COB)

• Insurance company code and name, Address, Policy number, Group number

• Subscriber identification

• Benefits covered under the policy

• Effective and termination dates for the policy

• Single or family coverage indicated

• Data integrated with the claims adjudication process

Events
Events are a flexible tool to track interactions between the Fund Office or Union and the member or participant or a family member. Events can be keyed by Fund staff, e.g., recording a telephone conversation or that a membership kit was mailed, or automatically generated by programs, e.g., if a particular letter was sent or a pension estimate sent to a participant. The events are coded to both facilitate reporting and analysis of activity and to allow security controlled filtering to display them to only those users who are permitted to see them.

 

HIPAA PHI Authorization
This function was developed to respond to the HIPAA regulations and allow the Fund to record whether members, spouses or adult children either authorize access to their PHI or block any such access to any individual, and what aspect of the PHI is covered by each request. These entries contain beginning and ending dates for the authorization or block and who made the entries and when they were entered. We prevent any deletion of these records to protect the audit trail.

Documents
The Documents tab is useful for recording the receipt of documents such as birth or marriage certificates, or requests for distributions from Annuity or 401K plans. If the documents are scanned, there will be an easy link to the image in this function.

Notes
In addition to the notes that can be entered associated with events, there is an unlimited ability to add other notes. Priorities can be assigned to them so as to make the most critical notes appear first. The notes can be searched by the content of the text or by the person who entered them. The id of the person who entered the note along with a timestamp is captured automatically.

CONTRIBUTION AND WORK HISTORY ENTRY AND POSTING
Contribution Entry
This function is used to enter or change the contributions made by an employer or self-payer and supports the use of a lockbox. The system provides the ability to handle a situation where one check is received in payment for multiple reports or multiple funds and allows the allocation of part of the payment to the other funds with a full audit trail so that cash receipts reports reflect the actual deposit and the future transfers will show as a receivable or payable from one fund to another. The cash receipts report summarizes all of these allocation payments, providing both the necessary detail backup to the periodic transfers and giving a simple net figure for each required transfer. Until the records have been posted to the permanent history file, changes or deletes may be made, however, once the reports are posted an adjustment function would be used that maintains a complete audit trail. There is also a miscellaneous debit/credit function that allows adjustments of various types and the entry of “non-contribution” receipts, such as payments of interest or assessments.

Work History Entry

• Allows up to 6 different types of work units to be reported for each member in a single remittance report.

• Different months can be attributed to the contributions for different funds.

• If the remittance has been submitted electronically, this function would be used to review the submitted report.

• Accommodates late posting of a member's work history received out of sequence and automatically posts to the work history file in chronological sequence.

• Allows for adjustments by accepting multiple postings for the same work period.

• Starting point for a manually-entered report may be:

  • All members specifically linked to an employer

  • All members who appeared on the previously returned remittance report.

• Changes and deletions:

  • Until the records have been posted to the permanent history file, changes or deletions may be made

  • Once the reports are posted an adjustment function would have to be used to ensure a complete audit trail.

   

 

Reconciliation
After the work history and contribution data has been entered, the system displays the total amount due (based upon the various contract provisions) and the amount paid (with detailed payment information) and shows any variances. The reconciliation screen allows the user to determine the appropriate distribution of the money beyond what has been done automatically.

WORK HISTORY DISPLAY

• Shows the complete work history for a member with sufficient detail to trace back to the source of the reported work

• Links to a display of the full remittance detail of the report

• Shows all of the work units reported, all the funds for which contributions were due and the rates applied to compute the amount due

• Shows posted and unposted data separately

• Flexible display filtering to allow focus on any time frame, contributions for a particular fund, or work for a particular employer

 

CONTRIBUTION HISTORY DISPLAY

• Shows the complete contribution history for a contributing employer

• Shows each individual report with the amount due, the amount paid and the difference

• Summarizes the net over or under for each accrual period

• Displays data with or without interest payments.

• Display can be requested for an individual fund, or for all funds, but the data is at all times segregated by fund, though it also shows grand total for all funds.

• Posted and unposted data shown separately.

• Links to an integrated imaging system to show images of the checks.

 

REMITTANCE BILLS
The system can generate a remittance bill for any employer that is flagged that it should receive such a bill. This function is always customized for each client’s needs. It can print members specifically linked to an employer if the Fund Office maintains these links, or include any members who appeared on the previously returned remittance report. It will print blank lines for the entry of any new workers and would have space to provide additional information for new workers. It can print all the funds and the rates for each, and would include within the list any fixed amount payments due such as a fixed monthly rate. The program can also include an itemization of any payments that are past due from earlier months and can add interest where appropriate. It can print on pre-printed forms or on blank paper or letterhead with the address placed to permit easy mailing in window envelopes.

RECIPROCITY
SSI’s CAS System recognizes the issue of handling reciprocity payments. If members are associated with a foreign local, the system is able to aggregate all the report information for members for that local for a requested period and to generate a remittance report to that local and its Funds listing all of its members and all necessary detail to accompany the required payment. Parameters are set up for each client that controls for which Funds reciprocity is done. Adjustment reports are automatically created to properly back out from each participant’s records the money that has been reciprocated. Foreign locals can also be set up as employers with the appropriate reciprocal rates so that reciprocal money can be received and entered just like any other remittance report.

REPORTS
The CAS system has a large number of standard reports, each with extensive flexibility as to what period of time, or for which employers or groups of employers, or in what sequence a report appear. In addition, other SQL reporting tools, e.g., Microsoft Access or Crystal Reports can be utilized to generate ad-hoc reports. Some of the key standard reports are listed below.

Cash Receipts
It clearly segregates receipts by Fund, including non-contribution receipts, and with the optional Allocation Report to summarize potential inter-fund transfers. It has a variety of sorting and totaling options as part of the standard program.

Delinquency Report
This reports employers who have not reported in a timely manner.

Over/Under Report
This report identifies and prints information about all remittance reports for which there is an underpayment or overpayment. It includes an option to fill in estimated amounts due for each unreported period based upon the prior period’s reports.

Benefit Coverage Census
This is a report as of any specified date of all participants eligible for a particular benefit. It can be created in either a summary or detail mode with totals by plan or carrier class and can be used to reconcile insurance premiums.

LETTER ISSUANCE AND TRACKING
The system can be used to generate form letters to members or employers with the inclusion of various data elements from the database. There is also a function to record that a custom “manual letter” was sent so that the historical record will be complete. There are easy links available from the member and employer screens so that one can review all associated letters. The letter function includes an automatic letter follow-up or diary capability.
SOCIAL SECURITY NUMBER CHANGE

• Function allows the change of an invalid or dummy social security numbers assigned to members to the correct social security number.

• The previous social security number and its date of change are available on member demographic screen.

• All history related to this person remains intact.

 

SOCIAL SECURITY NUMBER MERGE

• Function allows the merging of data where two sets of records under two different social security numbers exists.

• System performs validation of the merge and requires data “conflicts” to be resolved prior to performing the merge.

• The previous social security number and its date of change are available on the member demographic screen.

 

CHANGE LOG
The system creates a comprehensive change log that records the before and after image of the data that has been changed, as well as who made the change and when it was made. Supervisory staff can review or audit either selected changes or all changes made to the database. One can display all changes made to a particular member, or create a report by user or department for any date range. The analysis can be performed on selected files or tables allowing a focus on a particularly critical or troublesome area.