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Issue: Incorrect Open Enrollment Segments

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Number

0098

Submitting Entity (SE)

12231, 12567, 90328

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Update Date

Update

Incorrect disenrollment dates for 12567 have been corrected.

Incorrect disenrollment dates for 90328 have been corrected.

Description

Carriers with incorrect open segments

Active/Resolved

Active

Action / Resolution

Incorrect disenrollment dates have been found for the following entities. Resolution in progress. Workarounds described below:

12231 - River Valley moved to United A (79413A) in 2017.  However, River Valley disenrollment dates (ME163A) were not closed properly resulting in a significant number of open enrollment segments.  When the disenrollment date value is 9999-12-31, data users can assume disenrollment of 2016-12-31.

90328- First Health/Aetna stopped submitting eligibility data in 2019. Disenrollment dates (ME163A) were not closed properly resulting in a significant number of open enrollment segments.  When the disenrollment date value is 9999-12-31, data users can assume disenrollment of 2018-12-31.

12567 - Care Improvement moved to United Health (79413D) in 2017.  However, Care Improvement disenrollment dates (ME163A) were not closed properly resulting in a significant number of open enrollment segments.  When the disenrollment date value is 2199-12-31, data users can assume disenrollment of 2016-12-31.

UPDATE: This issue has been corrected for 12567 - Care Improvement. All segments ????

Category 1

Data Quality

Category 2

Enrollment Segments

Tip / Issue

Issue

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