PAYROLL OFFICE LETTER

U. S. Office of Personnel Management

Number:	P-97-06	Date: March 27, 1997

SUBJECT:	QUARTERLY REPORTING OF HEALTH BENEFITS DATA

Over the past few years, some of the Health Maintenance Organizations participating in the Federal Employees Health Benefits Program have filed claims against it. The basis of these claims has been the carriers' contention that they have not received all the FEHB premiums due them for their enrollees.

To address this area, OPM requires each FEHB Carrier to reconcile its enrollment on quarterly basis. To further this objective, Payroll Offices are required to provide carriers with the names of enrollees by payroll office and the premium paid for each of those enrollees for the current pay cycle. We are re-issuing the attached payroll office letter 92-06. Please be advised that, beginning with the quarter ending March 31, 1997, each payroll office must send the quarterly Health Benefits Reconciliation report to all health plans (not just prepaid plans).

At a minimum, you should already be providing this information in hard copy. We strongly encourage you to provide these data in an automated format, if possible. We have also enclosed Benefits Administration Letter 97-202, dated March 5, 1997, which suggests communication software for transmitting this report electronically via modem. We will continue to work with you and the carriers to strengthen the reconciliation process and provide the carriers with the necessary information to ensure the accuracy of their records. Your active assistance in this process is critically important.

Robert A. Yuran, Chief

Financial Management Division

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