Subject:

Agency HR Offices and the FEHB Clearinghouse

his BAL is to tell you about the FEHB Centralized Enrollment Reconciliation Clearinghouse, known as CLER for short, and to explain your role in the process.

OPM has contracted with the National Finance Center (NFC) to develop and operate a centralized system to identify FEHB enrollment discrepancies and coordinate their resolution. Here is how CLER will work.

Payroll offices will send the lists of FEHB enrollments they now send directly to the carriers each quarter, on March 1, June 1, September 1 and December 1, to NFC instead. Carriers will send their lists of enrollees to NFC at the same times. NFC will match the lists, identify discrepancies, and send the discrepancy list to the payroll office of record. The payroll offices, in collaboration with HR offices, will determine the enrollment status of each individual on the list.

Once the agency has determined the enrollment status of those on the list, either the agency or the carrier records must be corrected based on appropriate documentation. Agencies will have the option of having their HR offices submit information back to their payroll office for transmittal to CLER or having their HR offices do an electronic transmittal directly to CLER. Those agencies that want direct transmittal by their HR offices must make arrangements with NFC to connect those offices to the CLER web site. NFC will charge a fee for connecting each individual user, whether in a payroll office or an HR office, to cover the cost of security arrangements. Agencies are responsible for paying this fee.

Agencies will be able to make corrections either by sending data directly to the carrier via fax or mail or by sending data electronically to CLER, through their connection with the CLER web site, using the electronic 2809 and 2810 formats attached to this BAL. CLER will send this data back to the carriers.

Whether corrective data is transmitted to the carriers directly or electronically via CLER, each agency, through either the payroll office or the HR office, must then send NFC a Reconciliation Reason Code.

Once carriers receive information on a discrepancy, they must either process the data, correct their records, and let NFC know that they have done so, or notify NFC that they disagree with the corrective action. If they disagree with the corrective action, the carrier and the HR office must collaborate to resolve the discrepancy. CLER will enable OPM to identify discrepancies that remain unresolved.

In summary, each reconciliation cycle consists of three segments. During the first month, agency payroll offices and FEHB carriers submit their lists of enrolled individuals to NFC. NFC runs a computer match of the lists and sends discrepancies to the payroll office of record. During the second month, agencies use the appropriate internal processes to research the discrepancies and make a determination on the need for corrective action. If carrier records need to be corrected, agencies send appropriate information to the carrier either directly or through CLER. During the third month, the carriers make the corrections to their records and report back to CLER that they have done so. Please note that your research on and resolution of discrepancies is not necessarily limited to the second month of each three-month reconciliation cycle. However, corrective action data sent to the carriers electronically via CLER will be posted for the carriers only once per reconciliation quarter at the beginning of the third month.

We anticipate that full implementation of the CLER project will begin on June 1, 2002. We recommend that agency HR offices coordinate with their payroll offices to ensure that both sides have a clear understanding of roles and responsibilities prior to the implementation of this project.

If you have any questions on CLER, please call Mr. Eric Figg at OPM at 202-606-4083, or email at edfigg@opm.gov.

Abby L. Block Assistant Director    for Insurance Programs

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