PL0019 - CGIS38.pdf

South Carolina Department of Health and Human Services

(SCDHHS)

Member Management Replacement Program (MMRP)

Cúram Global Income Support (CGIS) Project

Architectural Description Document

(ADD)

CGIS38 South Carolina State Retirement System (SCSRS) Interface

MMRP CGIS Program ADD

CGIS38 SCSRS Interface V2.0 Page 2 of 156

Version Log

The Version Log maintains a record of the changes made to the document during its life cycle.

Whole number versions are reserved to designate that the document has reached an Approved status. Changes/Revisions made to approved documents will continue with decimals numbers, until the document again reaches an Approved status.

Version Date Drafted by Role Description of Change

0.1 11/07/2018 Tom Drennan Business Analyst Initial Draft

0.2 11/09/2018 Ken Haas Functional Business Lead

QA Content Review. Formatting will be standardized for Approval.

0.3 11/11/2018 Tom Drennan Business Analyst Incorporated Functional Business Lead’s comments.

0.4 11/12/2018 Tom Drennan Business Analyst Fixed formatting

0.5 11/12/2018 Tom Drennan Business Analyst Made corrections based on internal review

0.6 12/3/2018 Tom Drennan Business Analyst Fixed functional requirement references per SCDHHS request. Corrected 2 action item numbers.

0.7 12/12/2018 Tom Drennan Business Analyst Made corrections based on SCDHHS comments from Initial Draft ADD review.

0.8 12/13/2018 Tom Drennan Business Analyst Made corrections to reflect updated BRD and to address comments. Removed use cases no longer in scope.

0.9 12/20/2018 Tom Drennan Business Analyst Made corrections to address review comments.

0.10 01/16/2019 Tom Drennan Business Analyst Made corrections to address review comments.

0.11 01/21/2019 Tom Drennan Business Analyst Added PEBA file information.

Action Item #881 closed by Abhishek Sahu.

0.12 01/23/2019 Tom Drennan Business Analyst Updates made during Review Comments meeting.

0.13 01/23/2019 Tom Drennan Business Analyst Updates made during meeting with Abhishek Sahu.

0.14 01/28/2019 Tom Drennan Business Analyst Added Global Verifications ADD link. This document contains the CGIS Reasonable Compatibility process flow.

CGIS38 SCSRS Interface V2.0 Page 3 of 156

Version Date Drafted by Role Description of Change

0.15 01/29/2019 Tom Drennan Business Analyst Added new conceptual flows for New Application and Add A Member.

0.16 02/20/2019 Tom Drennan Business Analyst Fixed formatting. Added review and approval tables to match current template.

0.17 03/04/2019 Tom Drennan Business Analyst Updated comments and conceptual flows.

0.18 03/05/2019 Tom Drennan Business Analyst Updated and resolved comments during ADD - Review Cycle 3 - Q&A with State.

0.19 03/06/2019 Tom Drennan Business Analyst Document cleanup based on Review Cycle 3 meeting.

0.20 03/07/2019 Tom Drennan Business Analyst Document cleanup based on Review Cycle 3 meeting.

0.21 03/08/2019 Tom Drennan Business Analyst Updated document after Review Cycle 3 Part 2 meeting and submitted for Final Approval.

0.22 03/22/2019 Tom Drennan Business Analyst Added responses to unresolved comments. Replaced screen flow for SCSRS/PEBA file processing.

0.23 03/26/2019 Tom Drennan Business Analyst Resolved 3 remaining comments for FDS approval.

0.24 04/02/2019 Sudhakar Mattem Cúram Developer Updated the document with

TDS.

0.25

04/02/2019 Tom Drennan Business Analyst Cleanup of lump sum indicator reference for task.

0.26 04/22/2019 Sudhakar Mattem Cúram Developer TDS Review cycle 1 comments addressed.

0.27 05/02/2019 Sudhakar Mattem Cúram Developer TDS Review cycle 2 comments addressed.

0.28 8/14/2019 Tiffany Ortega IBM Functional Consultant

Added the following requirements per CR078:

CGIS_SCSRS_REQ_7.5

CGIS_SCSRS_REQ_7.5.1

CGIS_SCSRS_REQ_7.6

CGIS_SCSRS_REQ_7.7

0.29 9/11/2019 Tiffany Ortega IBM Functional Consultant

Updated requirement CGIS_SCSRS_REQ_7.7 to address comments from the state.

CGIS38 SCSRS Interface V2.0 Page 4 of 156

Version Date Drafted by Role Description of Change

0.30 10/23/2019 Rohit Arora Cúram Developer Updated Technical Design for

CR 78:

6.1.1 Sequence Diagrams

6.1.23 Service Layer

6.1.25 Service Layer Struct

Details

6.2 Unit Testing Scenario

6.3 ESB Development

6.5.2 PEBA Batch Detailed

Design

0.31 12/16/2019 Rohit Arora Curam Developer Updated pseudo-SQL for CR 78:

6.5.2.26 Coding Specifications

0.32 12/30/2019 Rohit Arora Curam Developer Updated 6.1.1 Sequence Diagrams,6.5.2 PEBA Monthly Batch Specifications, Added 6.5.3 PEBA Yearly Batch Specifications

0.33 1/23/2020 Tiffany Ortega IBM BA Lead Updated the following requirements per CR105:

1. CGIS_SCSRS_REQ_4.

3.1

2. CGIS_SCSRS_REQ_6.

3. CGIS_SCSRS_REQ_6.

4. CGIS_SCSRS_REQ_5.

5. CGIS_SCSRS_REQ_4.

6. CGIS_SCSRS_REQ_4.

7. CGIS_SCSRS_REQ_6.

1.2

Added the following requirements per CR105:

1. CGIS_SCSRS_REQ_6.

12.1

2. CGIS_SCSRS_REQ_5.

8.1

3. CGIS_SCSRS_REQ_5.

8.2

4. CGIS_SCSRS_REQ_5.

8.3

CGIS38 SCSRS Interface V2.0 Page 5 of 156

Version Date Drafted by Role Description of Change

0.34 2/13/2020 Tiffany Ortega IBM BA Lead Updated the following requirements per feedback from State:

Moved CGIS_SCSRS_REQ_5.8.2 to

CGIS_SCSRS_REQ_5.71.

Moved CGIS_SCSRS_REQ_5.8.3 to

CGIS_SCSRS_REQ_5.7.2

Updated

CGIS_SCSRS_REQ_5.7

Updated

CGIS_SCSRS_REQ_5.8

Updated

CGIS_SCSRS_REQ_6.11

Updated

CGIS_SCSRS_REQ_6.12

0.35 2/13/2020 Vinod Mandloi Developer Updated following section of

TDS

Section 6.1.14.8 Sequence Diagram Section 6.1.36 - Service Layer Section 6.1.19 Code Table Item

0.36 3/13/2020 Dibyendu Karmakar Developer Updated following section in

TDS:

Section 6.3 : Updated table names and JRecord link.

Added information that the report for PEBA will be in text format.

0.37 4/3/2020 Dibyendu Karmakar Developer Added sample PEBA reports for annual and monthly cycles.

CGIS38 SCSRS Interface V2.0 Page 6 of 156

Version Date Drafted by Role Description of Change

0.38 5/6/2020 Tiffany Ortega IBM BA Lead The following updates were made to align with CR105:

Updated CGIS_SCSRS_REQ_4.12 (first instance) Corrected

CGIS_SCSRS_REQ_4.12

(second instance) to

CGIS_SCSRS_REQ_4.19

Corrected the numbering for

CGIS_SCSRS_REQ_4.16

through

CGIS_SCSRS_REQ_4.21

Corrected the Section reference in CGIS_SCSRS_REQ_4.19 Corrected the Section reference in CGIS_SCSRS_REQ_1.5 Corrected the Section reference in Section 4.5.1 Design Description

0.39 9/3/2020 Tiffany Ortega IBM BA Lead Updated the template, spelling and grammar check for formal approval.

V1.0 9/17/2020 Erin Coleman MMRP Process & Artifact Development Manager

Updated date, watermark, and version to reflect approval.

Updated V2.0 to V1.0 in approval tables, updated Appendix D to be N/A, and accepted all track changes.

Updated section headers and table of contents.

V1.1 1/14/2021 Tiffany Ortega IBM BA Lead Updated the following requirements per CR323:

CGIS_SCSRS_REQ_4.13

CGIS_SCSRS_REQ_4.4

CGIS_SCSRS_REQ_4.20

V1.2 1/19/2021 Ashleigh Kelley IBM Developer Updated TDS section 5.1.19 for

CR323

V1.3 1/28/2021 Tiffany Ortega IBM BA Lead Updated the following items per

CR330:

CGIS_SCSRS_REQ_4.16

2.2.1 New Non Application

Process Flow Narrative #12 Account Code other than ‘01’ Task

Template

V2.0 4/11/2021 Erin Coleman MMRP Process & Artifact Development Manager

Updated date, watermark, and version to reflect approval.

CGIS38 SCSRS Interface V2.0 Page 7 of 156

The Review Logs maintains a record of the State personnel that performed reviews leading up to the document reaching an Approved status. These reviews do not represent final approval of the document. The Approvals are recorded in the Approval Log Section.

Functional Review Log

The Functional Review Log maintains a record of the State personnel that performed the review of the functional design, confirming the understanding of the design. That the design meets the requirements, business requirements as described and is testable.

SCDHHS Role First Review Date / Reviewer Name

Second Review Date / Reviewer Name

Third Review Date / Review Name

DDI Manager

Product Manager

Technical Lead

Business Analyst

Subject Matter Expert

Testing Manager

Technical Review Log

The Technical Review Log maintains a record of the State personnel that performed the review of the technical design, confirming the technical approach appropriately addresses the functional design.

SCDHHS Role First Review Date / Reviewer Name

Second Review Date / Reviewer Name

Third Review Date / Review Name

Technical Lead 11/1/2019 Ram and Renjan

Technical Lead 2/11/2019 Renjan Bhasi (Reviewed CR105)

2/12/2019

(Reviewed CR105)

Technical Lead 2/26/2020

(Reviewed CR78)

CGIS38 SCSRS Interface V2.0 Page 8 of 156

The IBM Approval Review Logs capture the IBM Project Team personnel that reviewed the completed ADD. The Functional and Technical Design Sections have been reviewed by the IBM team. The documented design, functional and technical components are understood as documented and can be validated through the Use Cases defined. This signifies that the section/document is ready for SC personnel review and Approval.

IBM Approval Review Logs

Functional Design Section

IBM Functional Design Approval Review – v2.0

Role Name Date Comments

CGIS Project Manager Courtney Stevens 3/25/2021 Approved v1.3 to v2.0

CGIS BA Lead Tiffany Ortega 3/25/2021 Approved v1.3 to v2.0

CGIS Testing Lead Brian Grieves 3/25/2021 Approved v1.3 to v2.0

CGIS Business Analyst Tiffany Ortega 3/25/2021 Approved v1.3 to v2.0

CGIS Development Lead Vijay Mujumdar 3/25/2021 Approved v1.3 to v2.0

CGIS Development Team Lead Randhir Singh 3/25/2021 Approved v1.3 to v2.0

Technical Design Section IBM Technical Design Review – v1.0

Role Name Date Comments

CGIS Development Lead Vijay Mujumdar 3/25/2021 Approved v1.3 to v2.0

CGIS Development Team Lead

Randhir Singh 3/25/2021 Approved v1.3 to v2.0

CGIS38 SCSRS Interface V2.0 Page 9 of 156

Approval Logs

Functional Design Section

The Functional Design Section captures the State personnel that reviewed and approved the functional design. Confirming that the design is understood, fulfills the requirements and is testable.

Functional Design Approval v2.0

Role Name Date Comments

SCDHHS DDI Manager Timothy Cozine 4/7/2021 Approved V1.2

SCDHHS Product Manager Abhishek Sahu 4/7/2021 Approved V1.2

SCDHHS Technical Lead Renjan Bhasi

SCDHHS Business Analyst Abhishek Sahu 4/7/2021 Approved V1.2

SCDHHS Process & Artifact Development Manager

Erin Coleman 4/11/2021 ADD Approved

Technical Design Section

The Technical Design Section captures the State personnel that reviewed and approved the technical design. Confirming that the technical approach to fulfilling design is understood fulfills the requirements.

Technical Design Approval v2.0

Role Name Date Comments

SCDHHS Technical Lead Renjan Bhasi

CGIS38 SCSRS Interface V2.0 Page 10 of 156

1 Table of Contents 2 Introduction

1.1 Background

1.2 Purpose

1.3 Scope

1.4 Key References

1.5 Definitions and Acronyms

1.6 Key Assumptions

3 Conceptual Flow

3.1 PEBA/SCSRS File Process Flow

PEBA/ SCSRS File Process Flow Narrative

3.2 New Non-MAGI Application Process Flow

New Non Application Process Flow Narrative

3.3 Add A Member Process Flow

Add a Member Process Flow Narrative

4 Requirements Matrix

4.1 Requirement Modifications

5 Functions

5.1 Validating the SCSRS file and storing it in ESB

Design Description

Functional Output

Design Details

Screen Flow – N/A

Screen Mockup – N/A

Business Rules – N/A

User Roles – N/A

CGIS38 SCSRS Interface V2.0 Page 11 of 156

Data Fields – N/A

Links – Navigation – N/A

Links – Functions/Actions – N/A

Validation – N/A

Notifications and Tasks – N/A

Other – N/A

5.2 Sending SCSRS member records to Cúram

Design Description

Functional Output

Design Details

Screen Flow – N/A

Screen Mockup – N/A

Business Rules – N/A

User Roles – N/A

Data Fields – N/A

Links – Navigation – N/A

Links – Functions/Actions – N/A

Validation – N/A

Notifications and Tasks – N/A

Other – N/A

5.3 Finding members in Cúram to add/update SCSRS information

Design Description

4.3.2 Functional Output

4.3.3 Design Details

4.3.4 Screen Flow – N/A

4.3.5 Screen Mockup – N/A

4.3.6 Business Rules – N/A

CGIS38 SCSRS Interface V2.0 Page 12 of 156

4.3.7 User Roles – N/A

4.3.8 Data Fields – N/A

4.3.9 Links – Navigation – N/A

4.3.10 Links – Functions/Actions – N/A

4.3.11 Validation – N/A

4.3.12 Notifications and Tasks – N/A

4.3.13 Other – N/A

4.4 Adding latest SCSRS information to integrated cases

4.4.1 Design Description

4.4.2 Functional Output

4.4.3 Design Details

4.4.4 Screen Flow – N/A

4.4.5 Screen Mockup – N/A

4.4.6 Business Rules – N/A

4.4.7 User Roles – N/A

4.4.8 Data Fields – N/A

4.4.9 Links – Navigation – N/A

4.4.10 Links – Functions/Actions – N/A

4.4.11 Validation – N/A

4.4.12 Notifications and Tasks

4.4.13 Other – N/A

4.5.1 Design Description

4.5.2 Functional Output

4.5.3 Design Details

4.5.4 Screen Flow – N/A

4.5.5 Screen Mockup – N/A

4.5.6 Business Rules – N/A

CGIS38 SCSRS Interface V2.0 Page 13 of 156

4.5.7 User Roles – N/A

4.5.8 Data Fields – N/A

4.5.9 Links – Navigation – N/A

4.5.10 Links – Functions/Actions – N/A

4.5.11 Validation – N/A

4.5.12 Notifications and Tasks – N/A

4.5.13 Other – N/A

4.6 Processing New Application and CoC Add A Member with SCSRS information

4.6.1 Design Description

4.6.2 Functional Output

4.6.3 Design Details

4.6.4 Screen Flow – N/A

4.6.5 Screen Mockup – N/A

4.6.6 Business Rules – N/A

4.6.7 User Roles – N/A

4.6.8 Data Fields – N/A

4.6.9 Links – Navigation – N/A

4.6.10 Links – Functions/Actions – N/A

4.6.11 Validation – N/A

4.6.12 Notifications and Tasks – N/A

4.6.13 Other – N/A

4.7 Generating Reports in Cúram

4.7.1 Design Description

4.7.2 Functional Output

4.7.3 Design Details Requirements

4.7.4 Screen Flow – N/A

4.7.5 Screen Mockup – N/A

CGIS38 SCSRS Interface V2.0 Page 14 of 156

4.7.6 Business Rules – N/A

4.7.7 User Roles – N/A

4.7.8 Data Fields – N/A

4.7.9 Links – Navigation – N/A

4.7.10 Links – Functions/Actions – N/A

4.7.11 Validation – N/A

4.7.12 Notifications and Tasks – N/A

4.7.13 Other – N/A

5 Technical Design

5.1 Common Technical Artifacts

5.1.1 Sequence Diagram

5.1.2 Events – N/A

5.1.3 Event Class Details – N/A

5.1.4 Domain Definitions – N/A

5.1.5 Code Tables

5.1.6 Code Table Details

5.1.7 Messages - N/A

5.1.8 Message Detailed Description - N/A

5.1.9 DMX

5.1.10 Security – N/A

5.1.11 Security Details – N/A

5.1.12 Model

5.1.13 Interfaces – N/A

5.1.14 Façades – N/A

5.1.15 Entity Layer

5.1.16 Service Layer

5.1.17 POD Definitions – N/A

CGIS38 SCSRS Interface V2.0 Page 15 of 156

5.1.18 Java Script Changes – N/A

5.1.19 CSS Changes – N/A

5.1.20 Global Configuration Changes

5.1.21 Wizard Changes – N/A

5.1.22 Menu Details – N/A

5.1.23 Evidence Configuration Changes – N/A

5.1.24 Renderers – N/A

5.1.25 Keywords (Hover Values) – N/A

5.1.26 Help Content – N/A

5.1.27 Links – Navigation – N/A

5.1.28 Links – Functions/Action – N/A

5.1.29 Validation – N/A

5.1.30 Workflow

5.1.31 Web Services – N/A

5.1.32 Java Classes – N/A

5.1.33 Task and Work queues – N/A

5.1.34 Reports – N/A

5.1.35 Unit Testing Scenarios

5.1.36 Cúram Unit Testing Scenarios

5.1.37 ESB Unit Testing Scenarios – N/A

5.1.38 Data Retention – N/A

5.1.39 Persistence Requirements – N/A

5.1.40 Backup Requirements – N/A

5.1.41 Archiving and Purging Requirements – N/A

5.1.42 Data Validation Checks – N/A

5.1.43 Security Considerations – N/A

5.1.44 Event Sequence Diagram – N/A

CGIS38 SCSRS Interface V2.0 Page 16 of 156

5.1.45 Coding Specifications – N/A

5.1.46 Table Names – N/A

5.1.47 Cúram Batch Component Technical Design – N/A

5.1.48 Batch Methods – N/A

5.1.49 Entity Classes – N/A

5.1.50 Entity Methods – N/A

5.1.51 Input/ Output Structs – N/A

5.1.52 Input/ Output Attributes – N/A

5.1.53 Technical Dependencies – N/A

5.1.54 Source-to-Target Mapping – N/A

5.1.55 System Properties – N/A

5.1.56 Page Parameter Details – N/A

5.1.57 Links/ Action Controls – N/A

5.1.58 Lists/Inline Page Details – N/A

5.1.59 Cluster Details

5.1.60 IEG Script

5.2 ESB Development

5.2.1 Outbound

5.2.2 Inbound

5.2.3 Supporting Details: Record Layout

5.2.4 ESB Operational – N/A

5.3 Rules Development

5.3.1 Rules (Rules Area) – N/A

5.3.2 Table of Values – N/A

5.4 Batch Development

5.4.1 Overview – SRS Income Update Batch Detailed Design

5.4.2 Functional Summary

CGIS38 SCSRS Interface V2.0 Page 17 of 156

5.4.3 Batch Specifications

5.4.4 Data Retention – N/A

5.4.5 Batch Classes – N/A

5.4.6 Batch Methods

5.4.7 Table Names

5.4.8 Input Table Names

5.4.9 TABLE STRUCTURE

5.4.10 Output Table Names

5.4.11 Cúram Batch Component Technical Design

5.4.12 PEBA Monthly Batch Detailed Design

5.4.2.1 Overview

5.4.2.2 Functional Summary

5.4.2.3 Batch Specifications

5.4.2.4 Data Retention – N/A

5.4.2.5 Batch Classes

5.4.2.6 Batch Methods

5.4.2.7 Table Names

5.4.2.8 Input Table Names

5.4.2.9 TABLE STRUCTURE

5.4.2.10 Output Table Names

5.4.2.11 Curam Batch Component Technical Design

5.4.2.12 Input/Output Structs

5.4.2.13 Input / Output Attributes

5.4.2.14 System Properties

5.4.2.15 Code Tables

5.4.2.16 Coding Specifications

5.4.3 PEBA Yearly Outbound Batch Detailed Design

CGIS38 SCSRS Interface V2.0 Page 18 of 156

5.4.3.1 Overview

5.4.3.2 Functional Summary

5.4.3.3 Batch Specifications

5.4.3.4 Data Retention – N/A

5.4.3.5 Batch Classes – N/A

5.4.3.6 Batch Methods

5.4.3.7 Table Names

5.4.3.8 Input Table Names

5.4.3.9 TABLE STRUCTURE

5.4.3.10 Output Table Names

5.4.3.11 Cúram Batch Component Technical Design

5.4.3.12 Input/Output Structs

5.4.3.13 Input / Output Attributes

5.4.3.14 System Properties

5.4.3.15 Code Tables

5.4.3.16 Coding Specifications

5.5 Non-Functional Requirements

5.5.3 Accessibility – N/A

5.5.4 Availability – N/A

5.5.5 Development Resource – N/A

5.5.6 Evolution – N/A

5.5.7 Globalization – N/A

6 Integration Points/Dependencies

7 Use Cases

8 Appendices

Appendix A: User Roles and Access Levels

Appendix B: User Roles and Workqueue Subscriptions

CGIS38 SCSRS Interface V2.0 Page 19 of 156

Appendix C: Action Item Matrix

Appendix D: PEBA Outbound File

Appendix E: Out of Scope Requirements – N/A

Appendix F: Comments/Resolution Log – N/A

Appendix G: Approval History – N/A

CGIS38 SCSRS Interface V2.0 Page 20 of 156

1 Introduction

1.1 Background

South Carolina Public Employee Benefit Authority (PEBA) also known as the South Carolina

State Retirement System (SCSRS) and the Department of Health and Human Services (DHHS) exchange information regarding members who are Medicaid eligible or applying for benefits and who are entitled to retirement benefits. Each month the SCSRS/PEBA provides a file of retirement income information for all South Carolina residents receiving retirement benefits. The file received in July includes the yearly cost of living adjustment (COLA) and provides the new state retirement benefit. For those members receiving state retirement benefits, the file documents benefit amounts, as well as indicates any insurance coverage.

1.2 Purpose

The purpose of this project is to

• Extend Cúram Global Income Support (CGIS) functionality to receive and process the monthly files from SCSRS (PEBA). This process is already in place for HCR (MAGI).

This effort will address any gaps between HCR and CGIS.

• Update the retirement income information of existing members in Cúram.

• Store for future use the monthly income information of members who are not registered in Cúram.

• Use the stored monthly income information to provide current, accurate retirement information for an applicant when they submit an online application through the Citizen

Portal or when a worker uses the Add A Member wizard.

The purpose of this document is to detail screen flows and changes needed in Cúram Global

Income Support (CGIS) to implement SCMMRP configurations, extensions and customizations to implement the CGIS solution only.

The intended audiences for this document are:

• MMRP Subject Matter Experts (SMEs)

• MMRP Cúram – Business Analysts

• MMRP Cúram – Architecture Team

• MMRP Cúram – Solution Developers

• MMRP Cúram – Testing Team

1.3 Scope

CGIS38 SCSRS Interface V2.0 Page 21 of 156

The South Carolina Member Management Replacement Program (MMRP) is being enhanced, as part of the Cúram Global Income Support (CGIS) project, to receive on a monthly basis retirement income information of SC state residents from the Public Employee Benefit Authority

(PEBA). The system is expected to update the existing member records who have retirement income included in the monthly file. When retirees do not exist in Cúram, the ESB is expected to store the SCSRS information for future reference. Cúram will have accurate and up-to-date retirement income for establishing eligibility when a retiree applies for Medicaid. The system will update member Unearned Income evidence with the SCSRS income reported in the file. The other SCSRS related data received on the file will be stored and updated whenever necessary.

SCSRS functionality has already been implemented for HCR. Some of this functionality will be transferrable to CGIS. Specific to HCR functionality needed for CGIS will be referenced in this document. The technical details of the HCR functionality will remain in the respective HCR

SCSRS Business and Technical documents.

The scope of this design is for the system to process the monthly SCSRS file; to update the

SCSRS information for members found in Cúram; to fetch the stored SCSRS data when a new application is submitted on the citizen or worker portal; and to use this state retirement income during eligibility determinations.

CGIS fetches the stored SCSRS data when CoC (Change of Circumstance) Add A Member script is invoked.

For the purpose of this design, CGIS is expected to update the Unearned Income evidence with the current reported SCSRS income at all times.

1.4 Key References

This section lists any key documents that might be helpful to understanding the functionality which are located on the MMRP SharePoint site in the CGIS Business Requirements and Design

Documents as an Approved/Reference document under the associated track.

Document Name Location

SC State Retirement System (SRS) CGIS Interface

BRD

SCSRS CGIS Interface BRD

MMRP HCR18.2 SCSRS Interface FDS Version 11.0

HCR18.2 SCSRS Interface FDS Version 11.0

CGIS Global Glossary for Global list CGIS Glossary

MMRP HCR18.2 SCSRS Interface TDS 2.0 MMRP HCR18.2 SCSRS Interface TDS2.0

MMRP CGIS 27 Global Verifications ADD 1.1 CGIS 27 Global Verifications ADD 1.1

SCMMRP CGIS 4&9 App Intake CMSP Task & Work Assignment ADD_V1.0

CGIS 4 & 9 App Intake CMSP Task & Work Assignment ADD V1.0 https://schhs.sharepoint.com/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/Forms/AllItems.aspx https://schhs.sharepoint.com/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/Forms/AllItems.aspx https://schhs.sharepoint.com/:w:/r/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS%20SCSRS%20BRD.docx?d=wc2cf4e7070ee4e47a6b53443da142eb7&csf=1&web=1&e=eu4bfS https://schhs.sharepoint.com/:w:/r/sites/1211207/Business%20Process%20Modeling%20Documents/HCR%20Tracks/Track%20HCR18.2%20-%20SCSRS%20Interface/Approved%20Documents/MMRP%20HCR18.2%20SCSRS%20Interface%20FDS.docx?d=w1e893b8de3884a21bd684c07f6732d5a&csf=1&web=1&e=UTC6rr https://schhs.sharepoint.com/:x:/r/sites/1211207/_layouts/15/Doc.aspx?sourcedoc=%7BD5695113-1D4C-45C2-9200-CF934E391D95%7D&file=CGIS%20Glossary.xlsx&action=default&mobileredirect=true&DefaultItemOpen=1 https://schhs.sharepoint.com/:w:/r/sites/1211207/Business%20Process%20Modeling%20Documents/HCR%20Tracks/Track%20HCR18.2%20-%20SCSRS%20Interface/Approved%20Documents/MMRP%20HCR18.2%20SCSRS%20TDS.docx?d=w5fdd153a4b774b5a835b8ce25080a1ec&csf=1&web=1&e=h4Jncj https://team.scdhhs.gov/pmo/ProjectRepository/1211207/_layouts/WordViewer.aspx?id=/pmo/ProjectRepository/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS27%20Global%20Verifications%20ADD.docx&Source=https%3A%2F%2Fteam%2Escdhhs%2Egov%2Fpmo%2FProjectRepository%2F1211207%2FCGIS%2520Business%2520Requirements%2520and%2520Design%2520Documents%2FForms%2FAllItems%2Easpx%3FGroupString%3D%253B%2523CGIS27%2520Global%2520Verifications%253B%2523In%2520Review%253B%2523%26IsGroupRender%3DTRUE&DefaultItemOpen=1&DefaultItemOpen=1 https://team.scdhhs.gov/pmo/ProjectRepository/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS%204_9%20App%20Intake%20CMSP%20Task%20_Work%20Assignment%20ADD.docx https://team.scdhhs.gov/pmo/ProjectRepository/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS%204_9%20App%20Intake%20CMSP%20Task%20_Work%20Assignment%20ADD.docx

CGIS38 SCSRS Interface V2.0 Page 22 of 156

1.5 Definitions and Acronyms

Term Definition

Bendex Beneficiary Earnings Data Exchange System

BRD Business Requirements Document

CGIS Cúram Global Income Support

CoC Change of Circumstance. Any change in an Individual's/Household's information which potentially impacts eligibility.

Col Change of Information. Any change in an Individual's/Household's information which will not impact eligibility.

COLA Cost Of Living Adjustment

CRCF Community Residential Care Facility

DAC Disabled Adult Children

DHHS Department of Health and Human Services

DOB Date of Birth

DOD Date of Death

DSS Department of Social Services

DWW Disabled Widows/Widowers

ES Essential Spouse

EWW Early Widows/Widowers

FBR Federal Benefit Rate

FMV Fair Market Value

FPL Federal Poverty Level

GH General Hospital

HCR Health Care Reform

IEG Script Intelligence Evidence Gathering Script

IT Income Trust

CGIS38 SCSRS Interface V2.0 Page 23 of 156

KB Katie Beckett

LOC Level of Care

MAO Medical Assistance Only

MAO-NH Medicaid Assistance Only-Nursing Home

MMIS Medicaid Management Information System

MMRP Member Management Replacement Program

MMRS Member Management Replacement System

NF Nursing Facility

NH Nursing Home

OSS Optional State Supplementation

PAC Pass- Along Children

PCAT Payment Category

PDC Product Delivery Case

PEBA Public Employee Benefit Authority

QDWI Qualified Disabled and Working Individuals

QMB Qualified Medicare Beneficiaries

RAP Refugee Assistance Program

SC MPPM South Carolina Medicaid Policy and Procedures Manual

SCSRS South Carolina State Retirement System

SDX State Data Exchange

SGA Substantial Gainful Activity

SLMB Specified Low-Income Medicare Beneficiaries

SME Subject Matter Expert

SSA Social Security Administration

SSI Supplemental Security Income

SSN Social Security Number

CGIS38 SCSRS Interface V2.0 Page 24 of 156

SVES State Verification and Exchange System

TEFRA Tax Equity and Fiscal Responsibility Act (Katie Beckett Children)

TMA Transitional/Extended Medicaid

TPL Third Party Liability

VA Veterans Administration

WD Working Disabled

1.6 Key Assumptions

• Existing HCR SCSRS processes will be followed, if an incoming file fails validations.

• CGIS Release 1 will implement the required external evidences: Income Details and

State Retirement Income. These evidences will mirror the existing HCR external

Income Details and State Retirement Income evidences.

• PEBA file share process will be defined to use HLQ location and will be documented and implemented as common interface standards.

• Cúram will not be aware of previous MEDS PEBA processing. Also, Cúram will not cross-check with MEDS whether the person record was previously sent in PEBA file.

Therefore, after conversion PEBA report may pick up the converted person and process without knowledge about previous MEDS PEBA processing.

CGIS38 SCSRS Interface V2.0 Page 25 of 156

2 Conceptual Flow

The flows captured within this section provide a high-level overview of the process. Please refer to the Functions section for the detailed requirements.

The high-level features for the SCSRS project include:

• Validating the SCSRS file sent by PEBA and storing it in the ESB

• Sending SCSRS member records to Cúram

• Finding members in Cúram to add/update SCSRS information

• Adding the latest SCSRS information to Income Support Integrated Cases

• Updating existing SCSRS information on Income Support Integrated Cases

• Processing New applications with SCSRS information

• Processing CoC/Add A Member with SCSRS information

• Generating monthly reports in Cúram

2.1 PEBA/SCSRS File Process Flow

This process flow describes the high-level monthly processing of the PEBA/SCSRS file as it moves through the ESB and Cúram.

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CGIS38 SCSRS Interface V2.0 Page 27 of 156

PEBA/ SCSRS File Process Flow Narrative

# Task/Process Task ID Narration

1. Process PEBA/SCSRS File 1 This groups together the steps required for the ESB to receive, validate, and transfer the data.

2. File Received From SCSRS 1.1 The ESB receives the monthly file for processing from PEBA/SCSRS.

3. Pre-Processing And Data Validation

1.2 The SCSRS file undergoes data validation checks

following the same logic as what has already been implemented for MAGI cases.

4. Pass Validation? 1.3 If the data does not pass the validation logic, exception reports and control totals that already exist for HCR are generated with the details. The report format complies with O & M standards for HCR reporting.

If the data passes the validation logic, it is sent to Cúram for processing.

5. Generate Exception Reports 1.4 Records that fail ESB validation are captured in exception reports. End of process.

6. Update Cúram 2 This groups together the steps required for Cúram to receive, process, and store the SCSRS data.

7. Create Income evidence Perform Person Search and Match

2.1 Income Support Integrated Case Unearned Income

evidence is created. CGIS uses external State Retirement Income evidence like HCR (MAGI) cases.

Cúram performs a Person Search and Match based on SSN. For every SCSRS beneficiary record, the system will check if the member exists in Cúram. The check will be based on the value for SSN of Person Receiving SCSRS Benefits. The SSN information of the beneficiary in the retirement file must have a unique match verified SSN with an existing registered person record in Cúram.

8. Raise Verification Unique Member Match Found?

2.2 When the Unearned Income IC evidence is created, a verification is raised. If the self-attested income and SRS data match, the verification is cleared automatically. If the Member reports retirement income but there is no record of it in the system, the verification remains in place. Manual intervention by a worker is required. Cúram determines whether a unique member match record is found. If yes, Cúram checks if the member is on an open Income Support IC. If no, Cúram skips processing the record.

CGIS38 SCSRS Interface V2.0 Page 28 of 156

9. Skip Processing The Record 2.19 If the search and match results in multiple person records in Cúram, unless there is only active record

(and the other member records marked as Duplicate) the member record must be skipped and not be processed. Such records must be displayed in the report mentioned in the Generating monthly reports in

Cúram section.

10. Is Member On An Open Income Support IC?

2.3 Cúram will check if the member is on an open

Insurance Affordability IC. If yes, Cúram will continue processing. If no, Cúram, will check if the member is on an open Insurance Affordability IC.

11. Is Member On An Open Income Support IC? No Is Member On An Open Insurance Affordability IC? No

2.3, 2.18 Cúram will skip further processing if a member is not on an Open Insurance Affordability IC.

12. Record will be processed by HCR SCSRS batch

2.17, 2.18 If member is a member of an Open Insurance Affordability IC, processes the record in the HCR SCSRS batch.

13. Is Member On An Open Income Support IC? Yes Is Member On An Open Insurance Affordability IC? Yes

2.3, 2.4, 2.17

Cúram will process the record on the Income Support and Insurance Affordability IC’s via the HCR SCSRS batch.

14. Compare Stored Value Attested With Value On Latest SCSRS File

2.6 CGIS compares the existing stored value to the

actual external State Retirement Income amount received in the most recent PEBA file.

15. Account Code 1 and Lump Sum = N?

2.5 If the record does not meet these criteria, a task is

created as outlined in 2.15 below.

16. Create Task And Assign To CGIS SCSRS Work Queue

2.15 CGIS will create a task and send it to the new CGIS

SC State Retirement System work queue if the Account Code is other than 1 and Lump Sum = Y.

17. Do The Values Match? Yes

2.7

Does the Member self-attested stored income match the income reported by SCSRS?

If the values match, no additional processing is required.

18. Do The Values Match? No

Create/Update Unearned Income With The Latest

2.9 If the values do not match, the Unearned Income

evidence of type State Retirement Income will be created or updated if one already exists based on the information in the latest PEBA file.

19. Clear The OV And Perform Case Reassessment

2.10 If the self-attested income and amount reported by

SCSRS match, outstanding verifications are cleared.

Cúram runs case reassessment.

CGIS38 SCSRS Interface V2.0 Page 29 of 156

20. Generate Outbound File to

PEBA

Impact On Benefits?

2.8 2.11 The system sends a monthly file to PEBA.

1: Member who were previously eligible and are in nursing home category whose eligibility was terminated because they are deceased OR they have been discharged from a nursing facility and have not returned within the last 6 months.

Annually in May (full file) and June (changes since the May file was sent), a file is sent to PEBA that contains persons who are Medicaid eligible and residing in a nursing facility.

CGIS will determine if there is a positive or negative impact on the remaining household members benefits. If there is not a negative impact, processing ends.

Member will be reassessed to check if he/she he is eligible for any other PCATs across other PDCs.

Similarly, other household members will be reassessed to check if they are eligible for any other PCATs across other PDCs.=

21. Update Income with SCSRS amount

2.9

The Unearned Income IC evidence is updated with the external State Retirement Income evidence amount. If an Unearned Income evidence of type State Retirement Income does not exist, one will be created based on the information in the PEBA file.

21. Determine Eligibility 2.10 Once the evidence changes are applied, CGIS redetermines Non- MAGI eligibility for remaining household members.

22. Generate Appropriate Notice 2.12 If the Member’s benefits are increased, decreased, or terminated by the recent update, a notice is generated. Remaining family members receive a notice based on adverse action rules.

If the member benefit changes from one PCAT to other PCAT (from one PDC to other PDC), then appropriate notices should be triggered.

23. Notice copy to OnBase 2.13 A copy of the notice advising the Member of their reduction or termination of benefits is stored in OnBase.

CGIS38 SCSRS Interface V2.0 Page 30 of 156

24. OnBase links Notice copy to Case

2.14 OnBase links a copy of the Notice

to the Income Support Integrated Case.

2.2 New Non-MAGI Application Process Flow

This process flow describes New Non-MAGI Application SCSRS processing as it moves through the Citizen or Worker Portal, ESB, and Cúram.

New Non Application Process Flow Narrative

1. New Non-MAGI Application 1 Title of the Conceptual Flow.

CGIS38 SCSRS Interface V2.0 Page 31 of 156

2. A Non-MAGI Application Is Submitted 1.1 Citizen or Worker submits a new Non- MAGI Application through their respective Portals. The ESB SCSRS information check is triggered at that point.

3. Does member have SCSRS income stored in the system?

1.2 CGIS will check if the member attests to

the income.

4. Member Attests To State Retirement Income? Yes

1.10 The member attests to having state

retirement income. The member is not present in the SCSRS files.

5. Create An OV For Income 1.11 Since the member attests to receiving SCSRS income and it does not exist in the SCSRS file, a verification is raised.

6. Member Attests To State Retirement Income? No

Member in SCSRS File? Yes

1.3, 1.8 The member did not report any SCSRS income.

Member is not present in the ESB SCSRS files. Continue the application creation process.

7. Member Attests To State Retirement Income? Yes

Member In SCSRS File? Yes

Does the attested value match the stored value?

1.2, 1.3, 1.4, 1.9

CGIS compares the amounts.

8. Create internal income with the attested value

1.9 CGIS will create an internal income with the

member attested value if it matches the stored value.

9. Continue the application creation process 1.8 CGIS will continue the application creation process.

10. Update the internal income evidence with the SCSRS value

1.5 CGIS will update the internal income

evidence with the SCSRS file value if the values do not match.

11. Clear the OV and mark as ‘E-Verified’ 1.6 CGIS will clear the outstanding Unearned Income verification once it receives a ‘gold standard’ SCSRS record.

12.

2.3 Add A Member Process Flow

This process flow describes CoC/Add A Member SCSRS transaction processing as it moves through the Worker Portal, ESB, and Cúram.

CGIS38 SCSRS Interface V2.0 Page 32 of 156

Add a Member Process Flow Narrative

1. Add A Member 1 Title of the Conceptual Flow.

2. Worker Completes Add A Member Wizard 1.1 Worker finishes the ‘Add A Member’ wizard in the Worker Portal. The wizard is considered done when it is marked ‘Complete’. The ESB SCSRS information check is triggered at that point.

3. ESB Check For SCSRS Record 1.2 ESB table with SCSRS records is checked for the member using Social Security Number (SSN).

4. Member Attests To State Retirement Income? Yes

Member In SCSRS File? No

1.3, 1.7, 1.8

The member attests to having state retirement income.

The member is not present in the SCSRS files.

CGIS38 SCSRS Interface V2.0 Page 33 of 156

5. Verification Raised For State Retirement Income

1.8 Since the member attests to receiving

SCSRS income and it does not exist in the SCSRS file, a verification is raised. End of process.

6. Member Attests To State Retirement Income? No

Member in SCSRS File? No

1.3, 1.4 The member did not report any SCSRS income.

Member is not present in the ESB SCSRS files. End of process.

7. Member Attests To State Retirement Income? Yes

Member In SCSRS File? Yes

1.5, 1.6, 1.7

Unearned Income Updated With SCSRS Amount

Unearned Income Marked As ‘E-Verified’.

End of process.

CGIS38 SCSRS Interface V2.0 Page 34 of 156

3 Requirements Matrix

This section provides the references to the Requirement Traceability Matrix (RTM.) The spreadsheet to upload the requirements to Jira is stored on SCDHHS MMRP SharePoint.

MMRP CGIS 38 SRS Interface ADD RTM

This section will document any subsequent changes to the RTM that may later be required as discovered through development, test execution, bug fix develop or training activities.

3.1 Requirement Modifications

This section will document any subsequent changes to the RTM that may later be required as discovered through development, test execution, bug fix develop or training activities.

Note: This section is used to highlight requirement changes, changes required to be addressed in by this design will be included in the Function Section as well as the RTM document and Jira.

4 Functions This section describes the detailed functionality of the system. The CGIS (Non-MAGI) approach will leverage the existing HCR functionality which is described below.

4.1 Validating the SCSRS file and storing it in ESB

Design Description

Currently, HCR (MAGI) receives a monthly SCSRS file from DSS with the information of

South Carolina residents who receive retirement benefits. The ESB file processing for the

SCSRS file already exists in Production for HCR (MAGI). CGIS requires some slight modification to process the SCSRS/PEBA file. This SCSRS file is stored in the ESB after performing data validations. If the data in the file is not in the expected format, the ESB generates exception reports for the invalid data. CGIS also generates control reports. The format

Requirement

ID

Business Rule ID

Description System Feature

Date Updated

In Scope (Yes or No) https://schhs.sharepoint.com/:x:/r/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS%2038%20SRS%20Interface%20ADD_RTM_.xlsx?d=wa4cb15944da74448a87e34ceb1069b3a&csf=1&web=1&e=ChO1I6

CGIS38 SCSRS Interface V2.0 Page 35 of 156 of the exception and control reports will comply with O & M standards in place for HCR reporting. When a new file is received and validated, the old file is replaced with the latest file received and stored.

Functional Output

• DSS system sends a monthly SCSRS/PEBA file to Cúram.

• ESB receives the file in Cúram.

• ESB does the required data validation.

• ESB generates a failure report if the validation fails.

• ESB stores the validated data.

Design Details

CGIS_SCSRS_REQ_1.1 The system will use the existing validation logic at the ESB level to process data sent by the SCSRS system for new applications and CoC/Add A Member.

CGIS_SCSRS_REQ_1.2 The system shall process the SCSRS/PEBA file on a monthly basis.

Note: The MEDS system currently receives the SCSRS/PEBA file. The file received in MEDS is a regular mainframe file, 154 characters fixed width. It is transmitted from DSS to the Clemson mainframe using Cyberfusion. The SCSRS/PEBA file is saved with a generation tag (ex.

MEDS.SRS.RBP503L1.COPY.G0174V00). This has already been implemented for MAGI. The

CGIS project will extend it for Non-MAGI. The technical approach to be followed by CGIS will be detailed in the CGIS TDS.

CGIS_SCSRS_REQ_1.3 ESB shall map the data elements in the file for every member record based on their positions and store them accordingly. The table below provides the list of data elements that can be extracted from the file based on their positions.

The table below provides the list of data elements that can be extracted from the SCSRS file based on their positions.

Element Description Type Position Length Data Element Name

SRS Retirement Code

Char 1 1 04 IN-SRS-CDE-RETIRE PIC X(1)

SSN of the Retiree Char 2 9 04 IN-SRS-NUM-SSN-RETIRE PIC X(9)

SSN of Person Receiving Benefits

Char 11 9 04 IN-SRS-NUM-SSN PIC X(9)

CGIS38 SCSRS Interface V2.0 Page 36 of 156

Payee Name

• Last Name

• First Name

• Suffix

Char

04 IN-SRS-NAM-PAYEE PIC X(46)

08 IN-SRS-NAM-LAST PIC X(25)

08 IN-SRS-NAM-FIRST PIC X(18)

08 IN-SRS-NAM-SFX PIC X(03)

POA Name Char 66 30 04 IN-SRS-NAM-POA PIC X(30)

Gross Amount of Benefit

Signed numeric decimal

96 9 04 IN-SRS-AMT-GROSS PIC S9(7)V9(2)

HDID Amount Signed numeric decimal

105 7 04 IN-SRS-AMT-HDID PIC S9(5)V9(2)

LTC Amount Signed numeric decimal

112 7 04 IN-SRS-AMT-LTC PIC S9(5)V9(2)

Lump Sum Indicator Char 119 1 04 IN-SRS-IND-LUMP-SUM PIC X(1)

Account Code Char 120 2 04 IN-SRS-CDE-ACCOUNT PIC X(2)

Date Created

• Year

• Month

• Day

Char

04 IN-SRS-DTE-CREATE PIC X(08)

08 IN-SRS-DTE-CREATE-YY PIC X(04)

08 IN-SRS-DTE-CREATE-MM PIC X(02)

08 IN-SRS-DTE-CREATE-DD PIC X(02)

Check Amount Signed numeric decimal

129 9 04 IN-SRS-AMT-CHECK PIC 9(7)V9(2)

Monthly Benefit Amount

Signed numeric decimal

138 7 04 IN-SRS-AMT-MO-BFT PIC 9(5)V9(2)

TL-REPAY Amount Signed numeric decimal

145 7 04 IN-SRS-AMT-TL-REPAY PIC 9(5)V9(2)

CGIS38 SCSRS Interface V2.0 Page 37 of 156

Vision TBC by SCDHHS – Added as an open item

Tobacco Surcharge TBC by SCDHHS – Added as an open item

Garnishment TBC by SCDHHS – Added as an open item

Check Code TBC by SCDHHS – Added as an open item

Filler Char 152 2 04 ILLER PIC X(02)

The following table shows the mapping of SCSRS retirement codes to corresponding SCSRS

Retirement Types:

SCSRS Retirement Code

SCSRS Retirement Type

1 State

2 Regular Police

3 General Assembly

4 Police INS/Annuity

5 Police Accidental Death

6 Judge/Solicitors

7 Firemen Pre 1989

8 National Guard

9 State Optional Retirement Program

CGIS_SCSRS_REQ_1.4 Data validation must be performed for every member record received in the file for the following data elements:

CGIS38 SCSRS Interface V2.0 Page 38 of 156

Data Element Name Validation

SSN of Person Receiving Benefits - The value must not be blank

- The value must be numeric only having 9 numbers

- The value must not be all zeros

- The value must not start with the number 9

SRS Retirement Code - The value must not be blank

- The value must be from 1 and 9

Gross Amount of Benefit - The value must not be blank

- The value must not be Non-Numeric

- The value must not be all zeros

HDID Amount - The value must not be Non-Numeric

LTC Amount - The value must not be Non-Numeric

Lump Sum Indicator - The value must be either Y or blank

Account Code - The value must be numeric only

Date Created - The value must not be Non-Numeric

Check Amount - The value must not be Non-Numeric

Monthly Benefit Amount - The value must not be Non-Numeric

TL-REPAY Amount - The value must not be Non-Numeric

Vision TBC by SCDHHS – Added as an open item

Tobacco Surcharge TBC by SCDHHS – Added as an open item

Garnishment TBC by SCDHHS – Added as an open item

Check Code TBC by SCDHHS – Added as an open item

CGIS_SCSRS_REQ_1.5 If any of the above validations fail, the existing HCR report will be generated. The detailed information on reports is captured in section 4.7.

CGIS_SCSRS_REQ_1.6 Every month when a new SCSRS file is received from DSS, the previous file will be deleted. At any point in time, only the latest file received from SCSRS will be stored in the ESB.

CGIS_SCSRS_REQ_1.7 The SCSRS file received may have multiple records for the same beneficiary (if they are receiving multiple state retirement incomes). The ESB will ensure that such records are grouped together and stored.

CGIS_SCSRS_REQ_1.8 The system will not check for duplicate records received in the

SCSRS file, as a member can have multiple retirement incomes for the same type of retirement.

CGIS38 SCSRS Interface V2.0 Page 39 of 156

Screen Flow – N/A

Screen Mockup – N/A

Business Rules – N/A

User Roles – N/A

Data Fields – N/A

Links – Navigation – N/A

Links – Functions/Actions – N/A

Validation – N/A

Notifications and Tasks – N/A

Other – N/A

4.2 Sending SCSRS member records to Cúram

Design Description

Each month when the SCSRS file is received from DSS, the ESB sends only the updated or newly added records to Cúram to process.

Functional Output

• DSS sends a monthly SCSRS/PEBA file to Cúram via the ESB

• ESB receives the file

• ESB checks for any new or updated records from the last received SCSRS file

• ESB sends the updated or new records to Cúram

Design Details

CGIS_SCSRS_REQ_2.1 Every month when ESB receives a new SCSRS file from DSS, the system will check if the income evidence already exists and compare (all attributes except “Date

Created”) the previous month file and the newly received file. Only the records containing updates or newly added must be sent to Cúram.

CGIS38 SCSRS Interface V2.0 Page 40 of 156

Note: Most of the updates would be in the COLA file received in July, but new records could be added as a result of any of the monthly files. The process of how to send the records to Cúram will be detailed during the TDS phase.

CGIS_SCSRS_REQ_2.2 If there are no new or updated records in the file, no information must be sent to Cúram, but the SCSRS file received from DSS must be stored in ESB for future reference until the next monthly file is received.

CGIS_SCSRS_REQ_2.3 In the current month file, if the existing SCSRS record is updated or if a new SCSRS record is added for the same member then the system must send all the member’s SCSRS records to Cúram so that the updated SCSRS income is created.

Screen Flow – N/A

Screen Mockup – N/A

Business Rules – N/A

User Roles – N/A

Data Fields – N/A

Links – Navigation – N/A

Links – Functions/Actions – N/A

Validation – N/A

Notifications and Tasks – N/A

Other – N/A

4.3 Finding members in Cúram to add/update SCSRS

information

Design Description

When records are sent to Cúram, the system must be able process each record in Cúram by checking if the SCSRS beneficiary is already registered in Cúram based on the information received from the ESB. The member search will be based on the SSN of the SCSRS beneficiary.

If the member does not exist in Cúram, no action is taken.

CGIS38 SCSRS Interface V2.0 Page 41 of 156

4.3.2 Functional Output

• The system checks if the SCSRS beneficiary exists in Cúram.

• The system checks if the member is on an open Income Support integrated case.

• The system checks if the member is an active case member (with no end date in past on the Household Member evidence) on the integrated case.

• No further processing is required if the member fails any of the above conditions.

• If the found member is on an open integrated case, even if there are any outstanding verifications on the case, the system can continue to process the record.

4.3.3 Design Details

CGIS_SCSRS_REQ_3.1 The system must store Member’s attested income for future references.

CGIS_SCSRS_REQ_3.2 When Cúram receives the SCSRS beneficiary records from the

ESB, the records must be processed asynchronously or in a separate process in a batch, by the system. If there are multiple records for the same beneficiary, they must be processed together.

Note: The CGIS Monthly SCSRS batch will be adhere to the same schedule as HCR with the possible exception in May/June.

CGIS_SCSRS_REQ_3.3 For every SCSRS beneficiary record, the system will check if the member exists in Cúram. The check will be based on the value for SSN of Person Receiving

SCSRS Benefits. The SSN information of the beneficiary in the retirement file must have a unique match verified SSN with an existing registered person record in Cúram.

CGIS_SCSRS_REQ_3.4 If the search and match results in multiple person records in

Cúram, unless there is only active record (and the other member records marked as Duplicate) the member record must be skipped and not be processed. Such records must be displayed in the report mentioned in the Generating monthly reports in Cúram section.

CGIS_SCSRS_REQ_3.5 If there is a unique member match in Cúram, the system must check if the member is a part of an open Income Support integrated case and at least one eligible member is on the open IC.

CGIS_SCSRS_REQ_3.6 The member must not have an end date (in the past) in the

Household Member evidence on the integrated case.

CGIS_SCSRS_REQ_3.7 The found member’s SSN evidence must be verified even though the member is on an open integrated case.

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CGIS_SCSRS_REQ_3.8 If a there is a unique member match in Cúram and if the member is on an integrated case (open or closed) even if they are marked as non-applicant, then the SCSRS record for that member must be stored. For open integrated cases with a unique member match, the information will be stored in Cúram. If there is an SCSRS record but no unique match or the member is on a closed integrated case, it will skip Cúram processing and be stored at the ESB level.

If the member is a part of multiple open ICs, the SCSRS information must be updated on all the

ICs. The internal Unearned Income and external Income Details and State Retirement Income…