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Eligibility calculations for each employee are based upon either hours
worked or dollars earned. The eligibility status is transferred to the payment
system via a HIPAA compliant ANSI 834 transaction. The 834’s may be created as
frequently as desired to prevent any lag time between eligibility notification
and claim presentation.
The system provides a web based capability for each employee to log onto
the system from a home based browser to view current bank hours and eligibility
status. Information dispersion is controlled by individual passwords selected
and maintained by the employee.
Hours/amounts in excess of a threshold may be accumulated towards the
hours bank totals. The hours bank may be used to allow coverage on periods for
which an employee fails to meet minimum work requirements. Coverage may be
calculated for partial as well as complete periods. Period terms may be
variable lengths for differing plans. Some plans may calculate monthly while
others may be quarterly. The system enables rules that allow virtually
unlimited combinations of plan requirements.
The user of the system has an option to create custom procedures for plans
that may be so complex that they will not fit within the standard rule tables.
These procedures may be used by one or more locals and or plans and will not
interfere with any plan procedures currently in use.
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