Generating HIPAA Triggers
The following events identified by the Government regulators as HIPAA Triggering Events, must be set up:
Dependent Coming of Age
Death of Covered Employee
Divorce
Legal Separation
Termination of Employee
Employee's Enrollment in Medicare
Termination of COBRA Coverage
Termination of Coverage without Enrolling in another
Each of these events should have the Trigger HIPAA Certificate flag set to Yes on the Personnel Action (PACT) page. Anytime Employee Status Maintenance (ESMT) or Department Specific Data (DEPTD) pages are updated using one of these events, a HIPAA Trigger will be created. Additionally, anytime a change is made to the Divorce / Separation Date on the Dependent Profile (DPND) page for the spouse of an employee, a HIPAA Trigger will be created.
The HIPAA Qualifying Transaction Table (HQTR) will be updated when a HIPAA triggering event occurs. HIPAA Triggers will be generated for the following events:
For Dependents Coming of Age, during the running of the Dependents Losing Coverage Report job (HB07000M).
For the Death of an Employee, when either Employee Status Maintenance (ESMT) or Department Specific Data (DEPTD) is updated with a Personnel Action code for Employee Death.
For Divorce, when Dependent Profile (DPND) is updated with a Divorce Date.
For Legal Separation, when Dependent Profile (DPND) transaction is updated with a Separation Date.
For Termination of an Employee, when either Employee Status Maintenance (ESMT) or Department Specific Data (DEPTD) is updated with the Personnel Action Code for Termination.
For Medicare enrollment, when either Employee Status Maintenance (ESMT) or Department Specific Data (DEPTD) is updated with the Personnel Action Code for Medicare Enrollment.
For COBRA Coverage ending, during the running of the COBRA Coverage Ending - HIPAA Program (HH07100M).
For Termination of Benefit Coverage without Reenrolling, when, during the employee Benefits Enrollment process, a benefit is waived, or when a Benefits Enrollment transaction is processed that expires a Benefit, and another transaction with the same Benefit Type Class (BTCL) code is not effective dated for the same date.
