Retirement Application Audit

Updated : Sep 29, 2019 in Articles

Retirement Application Audit


Good afternoon. My name is John Kogut, and Iím with Benefits
Officer Training and Development, and today we’re going to talk about the retirement
application audit. What we’re going to do, we’re going to look
at kind of the beginning of the audit, look at the case processing so when it leaves
HR and comes to OPM, the steps it takes and also weíre going to look at the, I guess,
most common errors of the audit and kind of ways to improve accuracy. And so, with that, when we say a healthy case,
what we mean is a healthy retirement application package, so one that is complete and not missing
information, and it does not have to be developed for that information. So basically, it comes to OPM, and we can
process the case and finalize the annuity for the retiree. So the application audit began in 2009. It was based on a six-week period of data,
and it was done annually up until 2012. And prior to that, the data was collected
from the claims examiners that were processing the cases. In 2012, the responsibility moved to the Retirement
Development Section, and this is where the CSRS & FERS checklist was created, and that
was in 2012. And the customer service specialists used
that in their Retirement Development Section to review cases and determine if they were
healthy or unhealthy. And also, that is where, then, the data was
taken for the application audit. And so, in 2014, we expanded the error definitions
because prior to that, the definitions were kind of vague, and oftentimes we were using
a miscellaneous, so it didnít cover all of the errors properly. So the definitions were expanded in 2014. We did send this information out in our ListServ
in October and November. We also had a YouTube webcast, tips on submitting
a healthy retirement application. And that goes over the new error definitions,
as well as ways to improve on those errors. And then, in 2015, we added one additional
definition, which is the marriage certificate that wasóprior to that, it was not required
in all applications, but as of fiscal year 2015, it is now required for all individuals
that are married and have a survivor annuity. So now weíre going to kind of look at the
purpose of the audit, and what that is is itís used to improve accuracy and completion
of the agency retirement packages because the more packages we receive that are healthy,
we can process those cases in a timely fashion and get annuitants into full retired pay. We also use our officeóBenefits Officer Training
Developmentóto reach out to agencies to give them training and guidance on their common
errors that we see and ways to improve upon those errors. It also can be used by the HR, the headquarters
benefits officer to use training internally. Whatever they see there, components may need
refreshers on, and itís also used for our strategic goal, and that strategic goal is
theówhat we call the 60 90, and that is to process 90% of our non-disability retirement
applications in a 60-day time frame, so that is also what the audit is used for. And kind of throughout the audit process,
weíve set goals on what we want the packagesóthe completeness of packages, so weíve got two
examples here: 2015, the goal was to have 85% of the retirement packages complete. That goal was met with an 87.5%. Then, in fiscal year 2017, the goal was also
85%, and we exceeded that goal with 90.8%. And for this year, for fiscal year 2018, the
goal is still 85%. The data is now collected at the back end,
versus the front end, so just kind of a change in that. I didnít want to increase the percentage
this year. Most likely, depending on what the overall
actually looks like at the end of this fiscal year, might up it for 2019. Here is a snapshot of when the audit began
in 2009. The baseline accuracy was 68.5%, and if you
kind of look through each year, the accuracy rate continued to go up. We did see a little dip in 2014, and that
was when we added the new error definitions to kind of capture the errors that we were
seeing that were delaying case processing. But after that, in 2015, it went up and itís
continued to go up since then, so we are seeing an upward trend, which is a good thing. And here is a snapshot from 2015. Itís just the quarterly breakdown, so Quarter
One, it was an 86.6%, and then the average of the four for fiscal year 2015 was 87.5%. And here is, from fiscal year 2017, total
cases reviewed was 41,237 cases. Of those cases, 3,791 had errors, and so that
came to the accuracy rate of 90.8, so again, a great year. Now weíre going to take a look at kind of
the outreach our office does to support the agency audit and guidance we can give to you. So the first we did is the retirement application
symposium. That was January 2009, as well as November
of 2012. Weíve also, since we brought back our spring
and fall festivals, weíve had our retirement application class in each one of those, so
weíll continue to offer that, and weíve also added a disability application processing
class as well. Weíve also done a few webcasts, a healthy
retirement package in October of 2012, and then in 2014, we did tips for submitting a
healthy application package. Again, like I mentioned earlier, that goes
over the new error definitions from 2014, and again, the most common errors at the timeóthey
obviously have changed a little bit since thenóand also, for the period while we were
not doing our in-person conferences, we did some virtual seminars, and in November 2014
and July 2015, we went over our retirement application audit update. Weíve also, along with the virtual and in-person
events, weíve also submitted or published some BALs. So the first was BAL 12-103, which is ìSubmitting
a Healthy Application Package,î and that came out in 2012, and that has the CSRS & FERS
Checklists that are used for the audit. So you have access to that. There are attachments, as well asóthe other
attachment is the case processing, or case order attachment, and then we also came out,
in 2012, 102 was the acceptance of photocopies of documents. And that goes into what documents we can accept
photocopies of that we donít need the wet signature on, and there is also a memo in
there that needs to be signed by the HR specialist thatís certifying that the document cameóthat
is, a photocopy of it came from an official source. And also BAL 14-103, it is on submitting retirement
FEHB benefits and kind of the documentation we need, and also we created a memo that can
be used if you donít have full documentation or if there is something off with the documentation. For example, if theyíre under their spouse,
you can submit the memo, along with the spouseís 2809s to just kind of show and explain that
theyíre under their spouseís FEHB program. Weíve also periodicallyówe havenít done
so in a while, but had Benefits Officer meetings where weíll discuss error trends for the
audit, and again, weíve sent out some messages on our ListServ as well, the 2012 error definitions
as well as then again for the update for 2014, and from our last webcast in 2014, we submitted
the question-and-answer portion, sent that out through the webcast as well. And the other piece that weíll doówhen I
sent out the monthly audit report to the headquarters-level Benefits Officer, we will sometimes include
job aids, as well as most-common errors and trends that we see so that headquarters level
can have that, and they can determine how they need to send that to the rest of their
HR specialists. And then, finally, the last piece that weíll
do, if time permitting and schedule, Iíve gone out to individual agencies to discuss
their specific errors and trends that we see with the audit. And the most recent BAL we submitted, published
was the BAL 16-102, and that is OPM is no longer accepting corrections on certain benefit
election forms. And it does go through all of them. I listed just a few on the slide. Some of the main ones, the 2818, continuation
of life insuranceóthere can be no scratch-outs, white-outs on that. The survivor election annuity form, as wellóthatís
another example that these forms, they cannot have any scratch-out, white-outs. Anything that you look at and may think that
could be considered a scratch-out, definitely want to have the annuitant or retiree submit
a new form so it doesnít delay the application process. And so, kind of the importance of the audit,
again, is to help us meet our 60 90 goal so we can process cases and get them finalized
as quickly as possible for the annuitants so we donít have toóagain, which would delay
the process if we have to develop for additional or missing information. Of course, there are instances where sometimes
an application is healthy, but we still have to go out for additional information. Thatís generally with deposits, re-deposit
letters. Another question I get often with the audit
is, ìWhy do my audit results include cases that were submitted months ago?î And thatís
due toóitís a few things. The cases are reviewed in the order we received
them in the Retirement Development Section, and also with our new process where the cases
are reviewed with the checklist in the Retirement Development Section, but the data is not collected
until the case is finalized in the annuity processing section. So that is creating a bit of a delay that
you will see on the 2018 audit results, the monthly reports. So again, weíre just kind ofómoved it there
to have the annuity processing section submit the data to myself to then process for the
report just so we couldówe donít want to cause any delays in application processing,
so thatís why weíve gone through this approach. And now, with the audit, cases that are reviewed
are all non-disability cases, except for deferred applications and direct submission, because,
again, the agency is not submitting these to us, so you have no control over what is
being submitted; that is, itís strictly just the former employee that is submitting that
documentation. And now, if you read ahead, youíll see, ìWhy
do reports have cases I canít identify?î And unfortunately, sometimes these deferred
applications do end up on the audit report. It does not happen often, but unfortunately
it does from time to time. And also, the other issue may be if an incorrect
submitting office number is put on the checklist, that could also cause a case to show up on
your report that you canít identify. Now what weíre going to do, weíll kind of
look at the case process. So once it leaves HR, the course it takes
to get to OPM, and then be finalized. So the first step is HR prepares the retirement
application, generally 20 to 100 days prior to retirement. Upon separation, the final SF 50 is cut and
the retirement package is sent to your Payroll Shared Service Center. And from there, Payroll Service Center will
send the what we call the information through the data exchange file, and thatís several
fields there that populates our electronics system. And then from there, two days after that,
they submit the actual package to OPM through overnight shipping. And again, this processówe got some dates
on there. Of course, it can vary, depending on the payroll
backlog at the time, how quickly they get the application out to us. And from there, once we receive the caseóso
a few things happen. The first is the data exchange populates our
front-end system, and that includesóthatís generallyó55% of the time, we are able to
put the retiree into interim pay from there because we get the health benefits information,
life insurance, final salary, as well as their service history, service history computation
date, so 55% of the time, like I said, the cases are put into interim pay. And from there, if theyíre not, the next
step is, once we receive the case file, itís then put together in the Retirement Preparation
Section, and what they do is they assemble the caseóthis is where they have the case
files created. They will put any documents weíve already
received fromóif an employee had time at another agency, they will give usóweíll
get copies of the former IRRs, if they have any military deposits paid in full. We will take that from either the physical
record or from the electronics system and marry that with the case so we have all the
information, and they will, in thisóin the Retirement Preparation Section, if they werenít
automatically put into interim pay, they will then put the retiree into interim pay, and
this can take five to seven days from receipt of the physical application package. Once the case is completed, it then goes to
the Retirement Development Section, and the Retirement Development Sectionóthis is where
the audit data is first captured on the CSRS & FERS Checklist. They determine if a case is healthy or unhealthy. If the case is healthy, they then forward
the case to the annuity processing section to process and calculate the retirement annuity. If the case is not healthy, they will initiate
the development, and then that depends what type of information is missing. If itís a marriage certificate, they would
go to the annuitant. If theyíre missing FEHB or life insurance
forms, theyíll go to HR, and of course, if any IRRs are missing, they would reach out
to payroll. And they will hold the case until they receive
the documentation, and then, once they receive the documentation and they determine the case
is then healthy, they will submit it to the Annuity Processing Section. And from there, the next step is the Annuity
Processing Section, and here, they will process the annuity. As they go through the case, if they determine
something was missed, they will send the case back to the Retirement Development Section
to get whatever is missing. This is also where, if thereís any election
through deposits or re-depositsóin other words, if they had excess deductions and theyíre
going to roll them overóthe Annuity Processing Section sends these letters out to let the
annuitant make a choice if they want to pay that deposit or not. And they will hold the case until they get
that feedback, and again, like I said, if the case is healthy, they will adjudicate
it, and once they adjudicate the case, the final step is for an auditor to review the
case to make sure there were no errors in calculating the case, and if everything is
good, they will finalize it and the annuitant will receive theiróany back pay owe and their
full monthly annuity. And here, again, like I briefly mentioned,
this is thenóonce the case is finalized, the customer service specialist will review
the CSRS & FERS Checklists from the Retirement Development Section and submit the audit data
to the audit inbox, which I then use andóto compile the audit, the monthly audit report. So youíre going to recap the steps that it
goes through. This all doesóyou know, weíve got estimated
time frame, but it does depend on how quickly received the case file from payroll, and then
also, depending on the time of year, if weíre in a surge or not, how quickly we process
the case. So again, it is all dependent on workflow,
on how quickly we can get these cases finalized. So itís kind of the case path process. What weíre going to look at next is the common
errors, the most common errors of 2017, and kind of ways to improve on those errors. And so here we are with the top five. The most common error of 2017 was the SF 2818,
and it was the election exceeded the coverage, and that was 16% of our errors; followed by
FEHB coverage , not having the five years of documentation, at 13%; followed by the
marriage certificate not being submitted with the application; and then the unacceptable
corrections; and then, finally, FICA pay rates were not submitted or they were incomplete. And so again, we are going to look at these
top five errors more closely and kind of look at ways to improve upon submission. So the first is the 2818, and that is the
elected coverage exceeds the permitted coverage, so the example would be the employee elects
to continue four multiples of Option B, but they are only allowed to continue three. The other that falls under this category is
if they elect to not enrolledóor not continuing coverage when they were not enrolled. Thatís another error that falls under that,
or vice versa in that. Some of the other common errors received with
the 2818óthe 2818 is missing or it is not signed by the annuitant. So some ways to improve that is to review
that 2818 before you submit the application package. Just make sure that theyíve signed and dated
the form, that theyíre not trying to continue coverage that they donít have. Another way to double-check would be just
to review the 2817s that you have and look through the OPF just to make sure that you
didnít miss anything, and again, just really let the employee know that we need the documents
submitted correctly because it will delay the claim processing because what weíll have
to then do if we get an incorrect form is weíll have to send it out to the annuitant
to have them complete the form correctly. And so now weíre going to look at the second
most common error, which is the FEHB, and that is theówe did not receive the five years
of coverage, so ideally, we would like all the–the employeeís entire career documentationó2809s,
2810s if you have them, but we only need the five years preceding retirement. The reason we like all of them is that helps
later on. If thereís a survivor claim, if we have all
the documents, we donít have to potentially request anything or go and obtain the OPF
to get any additional forms, just to verify dependents or survivor. And so thatís why we like all of that, and
again, acceptable proof is the 2809, the 2810s. We can also accept online service FEHB fact
sheets, history from your online systems, as long as it has the old plan, the new plan,
and the effective dates. We do need all of that. If we donít have that, that online printout
will not be sufficient. Also, if the retiring employee is under their
spouseís plan, we would need those 2809s to verify that they are a covered dependent,
or if theyíre under TRICARE, we need the uniform service card, whether itís theirs
or their spouseís, as well as CHAMPVA. We would need the CHAMPVAóa card or the spouseís,
just so we have proof that they are covered. And also, another thingóif the retirement
employee is under TRICARE and they are 65, over 65, we also need the copies of Medicare
A and B to verify that they haveóthat they are enrolled in that to continue TRICARE. And again, BAL 14-103 covers acceptable documentation
for FEHB coverage continuing into retirement. And also, it provides the memo, which can
be used if the documentation is not complete, or, like I mentioned earlier, if the documentation
is missing or if theyíre under a familyís FEHB, and just to kind of make it clear for
the claims examiner when theyíre reviewing that to know that they are under a spouseís
plan. And with that, this is what the form looks
like. Again, itís got the new plan, old plan, effective
dates, and the source where you got that information from, so 2809, online printout screen, whatever
it may be, and then you also want to sign and date that to certify the document is official. And this slide here isóI do want to mention
that it says that the certification memo is required in all cases. That was an error on my part. That is not the case. If you have the documentation to show the
five years, or if all the documentation was submitted, we do not need that certification
memo in addition. It is only if you donít have the five years
of documentation. And again, just to reiterate that we will
take a screenshot or the printout from your system, as long as it shows the five years
of coverage, as well as the old plan, new plan, and any effective dates that may have
happened. And so now weíre going to look at the third
most common error, which is the marriage certificate not being included with the application. And we have to have that if the retiree is
electing to provide a survivor annuity. If the marriage certificate is not there,
it will delay the claim, and we will have to reach out to the annuitant to obtain that,
and it can be a copy of the marriage certificate. So some ways to improve that would just be
ensure that all retiring employees submit their marriage certificates. If itís a common-law marriage, they need
to submit some affidavits or any other documentation that shows that they are in a common-law marriage,
just proof that they areóthey present themselves as a married couple. I mean, the other thing is, not all states
do recognize common-law marriage, so it has to be a state that recognizes common-law marriage. Another issue that we see is if the marriage
certificate is in a foreign language, we do need that to be translated. That can be done at the embassy, so, for example,
if the marriage certificateís in Italian, they could go to the Italian embassy to get
that translated, Department of State, or any other services that translate documents. And again, just ensure that the employee is
submittingófilling out their application correctly and putting any marriage information
that they have on there so it doesnít cause an error or delay the retirement application. The fourth most common is the unacceptable
corrections. Again, we do not accept any scratch-out, white-outs,
or anything like that. We need it to be a clean document. And again, I just put on here a fewóthe most
common forms we see that on, but again, the BAL does list every single document that we
cannot accept scratch-outs on. And again, the big one is the 2818, as well
as the application under the spousal section, as well as the spousal consent form. We cannot have any white-outs or scratch-outs
on that. And again, just to reiterate, BAL 16-102 has
that information so you can review. And again, if the annuitant doesnít wantóyou
know, if you go out to the annuitantóretiree, annuitantóthat they donít want to fill out
the document again, you just have to let them know that if they donít, once the form gets
to OPM, the application package, we will withhold the full annuity. We wonít process it until we get a clean
document, so thatís the best advice to give for unacceptable corrections. They justówe canít have them. We have to–weíll request a new form. Whether itís at HR level or OPM,weíre going
to need a clean form. And then the final error is the FICA pay rates. And again, this is the FICA earnings or pay
rates are not included on the certified summary or theyíre incomplete. We do need all those listed. If they have a deposit that they did not pay
off, or if itís for a serviceóprefer itís prior to 1189. And again, for postal, we need FICA earnings;
for FERS, if the appointment was three months or longer. And some ways to review to catch these errors,
really, is just to go through the OPF to make sure youíre not missing any FICA service
or re-deposit service. You can reach outóyou can check the data
viewer to see if thereís any documentation in there that shows that theómaybe they already
pay their re-deposits, if thereís any information on FICA in there. And then also, just ask the employee to see
if they recallóyou know, if anythingís missing, youíll have to ask the employee if they recall
doing any non-deduction service or if they had a re-deposit. And with that, weíre going to open it up
to questions, so please submit any questions to [email protected] and just address ìAgency
Audit Webcast.î Okay, first question. ìThere seems to be an issue with documents
not being received, even though they are sent in the package, as we keep copies of the package
for each retirement. We get dinged for documents that are supposed
to be missing, but when we check our records, we sent them, but our rating is not changed. Are there any plans for lawyers to review
the processes that are currently in place for receiving documents?î
Actually, and yes, I think part of that is, like I said, to the new learning curve for
the customer specialists in the Annuity Processing Section as of the beginning of 2018 has now
started handling the audit data collection. And also Iím planning to have a meeting in
the next month or so with the supervisors of that department to kind of go over feedback
that Iím hearing from the agencies on these types of issues, where youíre submitting
the documentation, but itís somehow being missed and said itís not there. So that is something that we are working on,
and Iíve sent most recently from the most recent monthly reports some feedback that
I received specifically about this. I think the issue was marriage certificates
that were submitted, but they were counted as an error. Sent that to the departments so they can review
it themselves and also, you know, give feedback to the customer service specialists that are
reviewing these cases to cut down on these types of errors and issues that weíve been
seeing, or the documents being there but counting as an error. Okay, the next one is a three-parter. First part: ìOn the 2818, if the employee
elected coverage during the 2016 open season, and is thus not eligible to continueóin other
words, they have less than five yearsódoes the employee mark yes or no when asked if
they want to continue? We know agencies identify on the agency checklist
what coverage can be continued. How does the agency identify what coverage
cannot be continued and why?î Thatís the first part. Iím going to have to double-check on that. My understanding would be that it would be
ìnoî because they are not eligible to continue, but I will do additional research and send
that response out through the ListServ. Okay, the second part deals with insurable
interest, the medical statement from the employee: ìIs the agency responsible for validating
if the statement defines ëgood and healthy,í as far as the employee goes? If the statement has an indication that may
not be, will OPM provide written determination to the employee to deny the insurable interest?î
That would not be through you. We would look at that. We generally send that through our disability
department to verify that if theÖhealthy enough to be acceptable for insurable interest. And the final part of that: ìWhat color ink
is acceptable on the forms, blue and black only?î
I would go with blue and black. Thatís a question Iíve never gotten. Thatís something I can double-check on, but
my understanding was anythingóany type of form, whether itís federal or state, Iíve
always used blue or black. So thatís one weíll double-check and can
send that out on the ListServ as well. Maybe what weíll do is send aósimilar to
the last webcast, kind of Q&A to anything that we donít get to today or we have to
clarify. All right, next question? Okay. ìHow can weóHR benefits specialistsóensure
we are receiving the OPM audit reports for our agency to know where the mistakes are
and learn to correct them? Iíve inquired with our main head office,
and they have not been able to get an answer of who is receiving them so they can be distributed.î
So what I do is I send that out to the headquarters benefits officer that we have listed on our
Benefits Officer web site at OPM. So if youíre an agency thatóif the benefits
officer is incorrect, you want to let us know, and you can let us know at [email protected]
because kind of what I do, I just send it to the headquarters benefits officer, because
if I were to send it to everyoneóevery HR specialist that requested, I just wouldnít
have time to get to all those requests. So we send it to the headquarters benefits
officer, and then they determine how they want to submit it or disseminate the information
to the rest of the agency or subcomponents. Okay. We have a question. Iím going to kind of summarize it for you. ìI have an employee that submitted a retirement
package for processing that did not provide a copy of her marriage certificate. She elected a surviving spouse benefit. I sent her a letter informing her that Iím
still waiting on the copy of the marriage certificate. Sheís not responded yet. She left May 11, so itís been over a month
now. Should I hold her package until I receive
the marriage certificate, or should I send it forward to OPM?î
You are not going to want to hold that application if theyíve already retired. Youíre going to want to send that to us. Unfortunately, it will be an error, but you
do not want to hold that application, especially if theyíve been retired for that long, because
I know there is the agent separation report that does go to Congress. So in this case, you know, youíve done all
you can. I would submit that to us, and now thatís
for us to deal with. And we will reach out to her to get it, and
if we donít, that may be something where weíll have to suspend the interim pay until
we receive that. Okay. Give me just a second here. Okay, before weíre off-topicÖ okay. Just a second. Okay. ìWhen we received the error reports,
we find that some of the errors arenít actually errors. Is there a dispute process? If OPM is reporting errors that truly arenít
errors, then how doóbasically, how do we deal with that?î
Unfortunately, at this time, we are not changing the error reports that we send out. We do not have the staff to go through all
the disputes and change each monthly error report. What I do is I do receive monthly from headquarters
benefits officers what theyíre disputing, and I keep a folder for that and I have been
submitting some of those to the supervisors at the Annuity Processing section, and thatís
also something that when we have the meeting, weíre going to talk about. I know, again, because weíre not getting
any additional staff thatóweíre not going to be changing those reports, but I am giving
them feedback, so kind of to improve upon so we can cut down on those errors that we
do make. Okay. ìPlease clarify. Is the current OPM Retirement Processing accuracy
percentage 85% or 90%?î So fiscal year 2017, it was 90.8%. That 85% was the goal. So I havenít run the numbers yet. I will most likely get to it. I might do a mid-year, but Iíll most likely
just wait till the end of the fiscal year to calculate what the yearly is for 2018. But the goalóso, I guess, just the goal weíd
like to see it beóat least 85%. But again, 2017, the overall accuracy rate
was 90.8%. Okay. ìWhere can I find a current OPM Retirement
Package Checklist?î The Checklists, I know, were sent out in November
of 2014, so if you donít have access to that, Iím sure thatís something we can submit
again on the ListServe, the most recent Checklist. I know BAL 12-103 has kind of the outline
of the Checklist, with the old one. We have added new definitions. Also, the webcast tips for submitting a healthy
retirement application package does go over the newóso if you need something immediately,
you can look at that webcast. It is on YouTube. Again, it was April 2014, and it does go over
the new error definitions that were added in 2014. So thatís just in the meantime, and again,
I think thatís something we can put out on the ListServ again, the most up to date. And again, the only difference in 2015 was
we just added that the marriage certificate is required. Okay. We have a question regarding the audit. ìWe have seen that we were charged an error
for FICA service and missing pay rates. However, in the case in question, FICA service
was after 12/31/1988. That service isnít creditable under FERS,
therefore we donít include the salary info. Can you confirm that we do not need to include
salary rates for FICA service after 12/31/1988?î Yes, that was clearly an error on our part
because if itís after 12/31/88, and itís not any of those special provisions where
they can receive credit for it, there would be no point to submit that, submit the salary
rates for something theyófor a service they cannot get paid or possibly get credit for. Okay. ìAre you doing any audit work on packages
that include divorces on acceptability of documents, and what is really needed to get
these processed faster? For example, Iím hearing agencies are not
requiring certified copies of divorce decrees or court orders.î
At this time, that is not something that theyíre looking at in the Checklists for this, for
the application audit. Okay, letís see. ìCould you please go over the fiveóì This
was regarding FEHB. ìCould you please go over the five-year rule and break in service? If an employee was covered for four years,
had a break, and then was reinstated and had one year of coverage before retirement, is
this still acceptable?î Okay, so Iím just understandóso they had
four years. They left service, came backÖ
For another year. For another year? So they had it continuously the whole time
they were employed. Yes, that wouldÖ that would cover them. Okay, give me a second here. Okay. ìI received an FEHB copy from the health
carrier, since it was missing from the employeeís eOPF. But the employeeís spousal information is
incorrect and shows thatóbut shows the spouse on the application. Will this be a problem when the employee retires? Example: ëAre you marriedí question states
ëno,í but it should be ëyes.í The application lists the employeeís spouse on the form,
and the coverage is self and family.î Could you repeat what it says? Surely. So they received an FEHB copy from the health
benefit carrier, since it was missing, but the employeeís spousal information is incorrect,
but shows the spouse on the application. So Iím assuming what theyíre asking is the
spouseís information is incorrect on the report that they got from the carrier, even
though theyíre showing self and family coverage. That should not be an issue. Okay. ìWould you please reiterate when we
need to provide proof of TRICARE or CHAMPVA coverage in a retirement application package?î
That would be if they areÖ well, I guess, if theyíre going to be suspending their FEHB
at retirement for TRICARE or CHAMPVA, or if they are under their spouseís or family memberís
plan, we would need that documentation of the spouse or family member to show that they
are covered under TRICARE. Or, again, if they themselves are suspending
at retirement, then most likely what we will do is weówhen we have that documentation,
we will reach out to them and send them the RI 79-9. Okay, letís see. Going to skip over that one. ìFive-year verification. BAL 14-103 states we can use online systems
to document coverage for FEHB if it shows the old coverage, new coverage, and effective
date. We are being charged with errors when providing
the above documents.î So I guess theyíre asking is thisóshould this be happening? No, that should not be happening. I have not seen anything to state that weíve
stopped accepting that documentation. Thatís just some, I guess, additional feedback
when I had the meeting with the Annuity Processing Section that collects the data that we can
go over to let them know that weíre still accepting that. Okay. Okay, give me just a second here. WhenÖ Okay. Thatís not really an audit question. Okay. ìIs it acceptable if applications are
completed in different-colored ink and/or half-typed and half-written if there are no
edits or corrections otherwise?î Iím going to have to double-check on that
one. I would think not, but I donít want to tell
you something and be wrong, so thatís something Iíll look into, and weíll put that on the
ListServ. Okay. Letís see. Okay. ìDocumentation at five years on FEHB
again. If we include all FEHB forms on file, and
we have continuity of coverage reflected for the last five years prior to retirement, will
agencies get an error if the FEHB documents go beyond the five years, donít show from/to
FEHB information chronologically, due to open-season plan name, code changes not captured on the
FEHB documents?î So I guess, to understand it, youíre submitting
everything, but thereís missing forms? ThatÖ
ìIf the FEHB documents beyond the five years donít show from and to FEHB information chronologically,
due to the open-season plan name change codes not captured on the FEHB documents.î So I
guess, if the plan changes their code mid-seasonó Oh, okay. That may be something theyíreójust to, you
know, obviously, without looking at all of it to determine how confusing it may be, that
may be something where you want to submit that memo from BAL 14-103 and just kind of
put on there the questionable periods. You know, maybe just put on there, you know,
that the code was dropped and they were placed in this other code because it was no longer
covered as an FEBH plan. You know, you could put that on there and
then put the source and sign it, just so itís clear to the specialist. Okay. Okay. ìIf HR does not get a marriage certificate
from the retiree, can HR include a memo for the record with the retirement case, saying
that we attempted to get the marriage certificate before the employee retired, so the agency
is not cited an error?î You can submit that, but my understanding
is that that willósince itís not there and itís an unhealthy case, it will still be
charged as an error. But you can submit that just soóyou know,
let the development team know that youíve already attempted to get it. Okay. I think you already addressed this in the
presentation, but Iím going to read it again. ìFor a long time, weíve included an FEHB
transfer memo that includes the current plan address, date of transfer. We include that, along with the five or more
years of FEHB elections. Do we still need to include this memo?î
My understanding is no, that memo does not still need to be included, as long as we have
the five-year documentation. Okay. Letís see. ìIf I say ënoí to basic life insurance,
do I still have to mark for A, B, and C? Can I type initials on the survivor annuity
election, or does it have to be pen and ink?î I wouldóso, if youíre electing ìnoî for
basic, I would just fill out the rest of the boxes, just to make sure that nothing is missing. It causes an error, even though, obviously,
without basic life insurance, you canít continue A, B, or C. And then what was the second part
of the question? Can they type in the initials, or do they
have to be pen and ink? For the survivor section? I wouldÖ I would do ink, just to be safe. Okay. ìIs the audit presentation recorded,
and can it be viewed later?î Yes, it will go on YouTube. Okay. Letís see. Letís see. Okay. ìRegarding the FICA salary details,
we are told by OPM previously that we needed to list FICA salary details even if a deposit
was already paid in full. Reading the slides today, it appears that
we only need to list the FICA salary details if the deposit is unpaid. Can you please confirm that this is the case?î
That is my understanding, but if youíve heard other guidance, I will do additional research,
and thatís something that I will add to the Q&A we put out on the ListServ. Okay, this is the second time this question
has come up, so itís not directly related, but itís indirectly related. ìAre there any plans to use electronic signatures
in the future, or possibly electronic submissions of retirement package to expedite the adjudication
process?î Itís a possibility, but not at this time,
that I am aware of. Okay. Letís see. Thatís a repeat. Okay. ìShould the 2818 be done if the employee
does not have FEGLI? Iíve always submitted one indicating ënoí
and written ëEmployee did not have basic FEGLIí on the form and had the employee sign
it, as they donít want the package to be held up because OPM is looking for the 2818. Should I continue this process, or not bother
with the 2818?î If they do not have FEGLI coverage, you do
not need to submit that. I would submit the most recent 2817, showing
that they did not elect coverage. And if they donít have it, they donít need
to fill out the 2818. Okay. ìEmployees who elect to retire without
giving the agency notice, who are covered by their spouseís federal FEHB, and the spouse
works for a different agency, does not allow the employing agency time to obtain the 2809
reflecting the coverage. The carriers will not release the insurance
information to the employing agency. They say that OPM must make contact with the
carrier and request the insurance information. How do we not get charged with an error for
this?î ThatÖ okay, Iím trying to think the bestóthatís,
I meanÖ so Iím just understanding the question, that theyíre under their spouseís plan,
theyíre retiring, but you canít obtain any documentation to verify that? Weíre going to need some type of documentation. If not, it will be an error because then we
will have to develop for that information. Okay. This kind of parallels that a little bit. Itís a little bit more direct. ìIf a spouse has been covered under the other
spouse, who is now a federal retiree, what documentation is required from the employee
when submitting the application to OPM for processing? Is the CSA number of the spouse carrying the
coverage sufficient?î Yes. So if they are retiring, and theyíre under
their spouseís plan whoís already an annuitant, yes. Generally name, CSA number, something so we
can verify and look in their case for the FEHB documents. Okay. ìTo clarify, we only need to submit
marriage certificate if the employee is selecting a survivor election?î
Yes. If theyíre not married, obviously they wouldnít
have one, or if they have the spousal consent form, it is not required. Okay. And it should say providing no survivor annuity,
but partially youíll want to submit that as well. Okay. ìIf the employee has prior FICA service
that is creditable for retirement purposes and intends to pay the deposit with OPM when
they retire, would we want to submit the 3108 form, along with the employeeís retirement
application?î So theyíve not sent that in already or established
anything? No, you do not need to send that because the
claims examiner, when theyíre processing the case, will calculate the amount of the
deposit and send a letteróeither send a letter or contact the annuitant over the phone to
see if they want to pay that. Okay. ìWill OPM charge an error if the Schedule
A, B, and C form is not provided when the employee does not have military service, is
not military-retired, and never filed any OWCP claims? According to the form instructions, the form
is not applicable in this situation. We were previously advised by OPM that the
Schedule A, B, and C is required even if not applicable, and the employee should complete
their name, date of birth, Social Security number in the first section, then sign and
date the bottom. Is this correct?î
Yes, I would continue doing that guidance whereóbecause if we donít receive it, we
donít know if they do or do not have prior military service or an OWCP claim, so they
should submit those and justóeven just check ìnoî and sign the documents. Okay. ìIn regards to marriage certificates
and translators, is it always necessary that a translated copy be sent? In the past, weíve not had to do this.î
Yes, we do need it translated because if itís not translated, we may not understand what
it says, and we would then have to reach out for that, so it would be an error. Okay. Okay. ìIn the case where another agency has
not documented FEHB coverage in the case of a transferred employee, is it also permissible
to use proof of coverage provided by the insurance company via a letter of coverage to augment
the spotty insurance documentation?î So I guessÖ if the letter shows the prior
plan and the new plan dates, if all thatís covered, that should not be an issue. Okay. So I guess I should say, from my experience,
when I was claims processor, we were able to call the carrier, and they were able to
give us the information. Say, John Doe was in Blue Cross Blue Shield
from such-and-such a date and then changed plans, they would give us that information,
and we would take that as report of contact over the phone. So, I mean, even if you can do that and submit
that, just, again, we just need the documentation to show the old plan, new plan, and effective
dates. Okay. ìDoes OPM require that payroll sign
the SF 1150s with a hard-copy signature, or will OPM accept an electronic signature?î
We do not accept electronic signatures. Letís see. ìIf we get a faxed copy of the 2818 and verify
everything is correct, will you still require a follow-up with the original?î
I would check BAL 12-102. I donít remember off the top of my head,
but it does, on there, list every form that we can take a photocopy of. Okay. Already answered this one. Letís see. Okay. ìIs there a recommended timeline the
retireeís signature date of the application, i.e. retired 12/31/18 and the date of the
application is 6/20/18?î I guess theyíre asking how long from the time the person fills
it out until the time they actually retire. Generally, we would like that within a year
from when they sign that form, within a year. If itís after a year, we would wantóitís
kind of stale-dated, and weíd want a new form with a new signature. Okay. Looks to be thatís it for the questions now,
so if we donít get anything in another minute or two, that will conclude the webcast today,
and like I said, anything that wasnít clear, Iíll send out a Q&A on the ListServ, and
any questions that might come in later today that werenít answered, I will add those to
the Q&A as well. All right, and that looks like thatís it,
so thank you for watching the Agency Application webcast today.

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