Issue: 47155 Open Enrollment Segments 2013-2014

Number

0136

Submitting Entity (SE)

47155

Add Date

Sep 14, 2023

Update Date

May 16, 2024

Update

Included in the May 2024 Data Tips email.

Description

THIS ISSUE HAS BEEN RESOLVED.

Because Delta Dental (41755) changed systems in 2015, over 400K eligibility segments remained unclosed in the years 2013-2014. Also, member numbers changed between the two systems. Because the segments remained open and the member numbers were different, the older segments were treated as still active, artificially inflating active member counts.

WORKAROUND:

Until this issue is resolved, the recommended methodology to manage these segments is:

Group members on Study_ID (ME998+ME013), Insured Group or Policy Number (ME006), Date of Enrollment (ME162A) where ME001 = ‘47155’

When Carrier Specific Unique Member IDs (ME107) are different, use the segment records where Date of Disenrollment (ME163A) is not null.

 

 

Active/Resolved

Resolved

Action / Resolution

The affected segments were closed in the 23C build and were released in Spring 2024.

Category 1

Data Quality

Category 2

Delta Dental

Tip / Issue

Issue