This report displays terminated employees eligible for COBRA. It also sets the COBRA Notification flag to 'T' on the HMTU1 record in effect as of the employee's termination date and all subsequent HMTU1 records. This ensures that the employee is not reported more than once. This flag is not displayed online.
Report Criteria
| Category |
Benefits Administration |
| Distribution |
Agency |
| Frequency |
Upon request |
| Form |
924 |
| Sort Sequence |
| Options |
H0XCR Sort |
| Employee Name, Employee Number |
1 |
|
| Page Break |
|
| Parameters |
|
| Databases Used |
HID, H0B, HMT, H0C |
| Selection Criteria |
Terminated employees other than transfers, who are not retired, have not previously been reported, and have an HMTU1 record. |
| Produce Output? |
Yes |
| Request Screen |
HSRPT |
| Posting Report? |
Yes – Updates HMT.CBREVNT. |
| Additional Notes |
|
Report Headings
- EMPLOYEE NAME HID.RPTNAME
- Displays the employee's name.
- EMPLOYEE SSN H0B.EMPLOYEENO
- Displays the employee's SSN.
- TERMINATION DATE H0B.TERMDATE
- Displays the employee's termination date.
- HEALTH CARRIER HMT.HLTHCARECD
- Displays the active health carrier providing coverage as of the termination date. If coverage does not exist, then NO will display.
- HEALTH LEVEL HMT.HLTLLVLCD
- Displays the level of health insurance coverage in effect on the termination date.
| MO | Employee only |
|---|
| MS | Member and spouse |
|---|
| MC | Member and children |
|---|
| MF | Member and family |
|---|
| NO | No coverage |
|---|
- DENTAL CARRIER HMT.DNTLCARECD
- Displays the employee's dental insurance carrier as of the termination date.
- DENTAL LEVEL HMT.DNTLLVLCD
- Displays the level of dental insurance coverage in effect on the termination date.
| MO | Employee only |
|---|
| MS | Member and spouse |
|---|
| MC | Member and children |
|---|
| MF | Member and family |
|---|
- ELIGIBLE DEPENDENTS NOTIFIED FOR COBRA
- Displays a value indicating whether or not there are eligible dependents that need to be notified, based on the coverage level.
Sample Report
REPORT: 036 UNIFORM STATEWIDE PAYROLL/PERSONNEL SYSTEM PAGE: 1
AGENCY: XXX XXXX XXXXX XXXXXXXXXXX XXXXX RUN DATE: XX/XX/20XX
EMPLOYEES ELIGIBLE FOR COBRA COVERAGE RUN TIME: 2:00:00
TERMINATION HEALTH CENTAL ELIGIBLE DEPENDENTS
EMPLOYEE NAME EMPLOYEE SSN DATE CARRIER LEVEL CARRIER LEVEL NOTIFIED FOR COBRA
------------- ------------ ------------ ------------- ------------- -------------------
XXXXXX, XXX XXXXXXXXX 02/05/20XX NO NO
XXXXXXXXX, XXX XXXXXXXXX 01/21/20XX NO NO