Annually at this time we update you on changes to the file format for health benefits enrollment changes made electronically through Employee Express and the Macon Hub. We are not making any changes this year. As we will be HIPAA compliant next year, this will be the last year you will have to use our electronic format.

HIPAA Compliance

We are in the process of making the electronic transactions HIPAA compliant. As we said in FEHB Carrier Letter 2002-02, dated January 28, 2002, we planned on generating HIPAA compliant enrollment files (ASC X12N 834 - Benefit Enrollment and Maintenance, Version 4010) for the electronic enrollment system (Employee Express and Macon-Hub) by October 16, 2002. However, we and OPM-Macon requested extensions under the Administrative Simplification Compliance Act. We now must be compliant by October 16, 2003. Our OPM-carrier workgroup continues mapping the current Employee Express/Macon-Hub file layout to the HIPAA compliant layout. We plan to begin testing on our HIPAA data conversions in March or April next year in order to ensure that we are compliant by the October 16, 2003 deadline. We are looking for testing partners. If you want to volunteer, please call Mr. Jay Fritz at 202-606-0004 or email Jay at jdfritz@opm.gov.

Individual File Layout

For those carriers new to the FEHB Program for year 2003, Enclosure 1 shows the Individual File Layout. This is the same format we issued in September 2001.

Federal Agencies Participating in Electronic Enrollment Transfers

Enclosure 2 lists the agencies that will participate in Employee Express or transmit data through the Macon-Hub. Agencies that have recently agreed to send their transactions electronically are shown in bold type.

Receiving and Processing Your Electronic Enrollments

For review, you currently have an FTP connection with OPM-Macon. If you are a new carrier for 2003, you will need to establish an FTP connection with OPM-Macon. If you have questions, please call OPM-Macon. Either Chris Selle (478-744-2115) or Sidney Beach (478-744-2320) will be able to assist you.

For the "pull" technique, OPM-Macon will send you an email notifying you that they have posted new enrollment data in your account for you to pick up. They will send this email to your official plan contact and your enrollment contact, as well as the OPM contract specialist. Although you should check the FTP server every week for enrollment changes, these e-mails will remind you to pick up enrollment changes.

OPM-Macon will post your enrollment change report for Employee Express to the FTP server every Sunday from the beginning of November 2002 through the end of January 2003. After that, OPM-Macon will provide you a file only when there is data to transmit.

Again this year, we expect you to process enrollment change information quickly and efficiently. Let me emphasize again the importance of processing electronic enrollments once you receive them. Electronic processing is a contractual requirement and you are accountable for it.

If you have questions regarding the FEHB and Employee Express, please contact Eric Figg at OPM at 202/606-4083 or via email at edfigg@opm.gov.

Sincerely, Abby L. Block Assistant Director    for Insurance Programs

Enclosure 1, Individual File Layout [Word File]  [PDF File]
Enclosure 2, Participating Federal Agencies [Web Page]  [PDF File]

Download this Letter as a PDF File (72K File)