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Out of the Archives - Case History 'B'

Stats:

Active Members = 4,500
Retirees = 1,500
Dependents = 14,500
Average Lives in System (with turnover) = 49,000
Health and Welfare Benefit Program = 95% participation
Document images = 320,000
Locals = 10
Employers = 18
Dues from Payroll Deductions = Yes
PAC from Payroll Deductions = Yes
Employer Provided Datasets = up to 3 per Employer

• Active Payroll with Dues Deductions
• H&W Benefit Remittances for Active Employees
• H&W Benefit Remittances for Pensioners

Over The Counter Operations = Yes, Print Receipts
User count = 20
Years MTSS in use = 10+

Why:

MTSS was brought into this organization to replace another product which was not multi-user and otherwise outdated. The organization needed to track the dues and membership information collected from multiple employers. They also had a Health & Welfare Fund that provided a health benefits program to the active membership and the retirees. For these benefits, the system needed to track the payments that were due and those that were paid. This included amounts from members as well as remittances from employers for the employer portions. Calculation of eligibility for benefits was tied directly to membership. It was also needed that the system report on dues and benefit payment shortages and generate statistical member and benefits information.

The data in the existing system was very sparse and therefore, so was reporting.
Often eligibility termination information was not able to be sent to health providers in a timely manner. And even if it was timely, it was not traceable. There was no document imaging system in place. When asked to produce evidence that timely benefit termination notification had been given, the staff would need to search through rooms of filed storage for the transmittal forms. However, it was seldom that such forms were ever located within the time frame allotted.

As a result of these conditions, this organization was incurring losses due to unreported shortages and provider over-billings.

MTSS was requested to fulfill these needs and allow information from source documents to be readily retrieved and viewed at point of need.

How:

During the pre-staging process, considerable time was spent with the staff in surveying the operational procedures and requirements of the organization and its related entity the Health & Welfare Fund. This included a review of the types of physical documents which were available such as the benefit option selection forms for participants, other enrollment forms, union membership cards, birth certificates, etc. Information was also gathered on the various business processes such as how the dues and benefits payments from employers and individual members were handled, and the methods for advising benefit providers of changes in the eligibility of program participants. At this time we evaluated the types of member requests being serviced and how they were handled.

Demographic information was gathered for employers, benefit providers, locals, etc. that would be incorporated into the system. System calculation rules were also identified.

The MTSS modules selected provided for multiple dues rates including percentage dues, multiple health benefit plans with different coverages and separate member contribution rates. Included were split premium processing for benefit payments and benefit coverage type splits for same family plans. Also included were modules for grievance tracking and union officer history. Input processes for these was permitted at individual workstations or via automated intake of payments from employers’ data files. Multi-level security was also implemented. Of course all of the modules permitted simultaneous use by multiple users at individual workstations at varying locations.

To have a complete and useful historical record in the new system, it was clear that most historical information would have to be gathered from original sources and rebuilt. This was necessary because the data in the existing computer system was incomplete and outdated. As the physical documents were gathered from the various files and storage rooms and areas, the collating effort began. The documents were assembled into packages each associated with the correct member. Each package was then passed from team to team for various corrections and to research still missing information. Slowly the packages contained all of the historical and demographic information needed to populate the new system and data intake began. At last the documents in each assembled package were scanned into the system. Each package was then permanently filed with a system generated id# to facilitate easy identification in the future, should it ever be needed again.

As the intake process continued, we worked with the staff in order to test each of the modules to insure that everything worked together smoothly, was user friendly, and that the modules were providing the desired information. The document imaging was tested with each module as it came up. Testing the repository of documents, which was growing day by day, was very satisfying to watch as information previously thought unobtainable would leap from the screen in mere moments.

When:

When MTSS was turned on, the users were already as familiar with it as a reliable friend.
Processing steps seemed second nature. All so fast and smooth! The whole thing appeared wonderfully seamless.  Thus the organization from (actually before) day one, began to collect under payments and prevent invalid charges from benefit providers for terminated parties. Membership information could now be accurately reported and was instantly up to date. Dues could be accurately distributed and reported. Membership lists could be generated into mail lists. Cobra and other notices were system generated. And of course the staff was very happy with all the information available and the ability to get at it simply, whenever they needed it.

Different story – same ending.

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