Unemployment Compensation Project Phase 2

Transcription

1 State of Florida Agency for Workforce Innovation Unemployment Compensation Project Phase 2 To-Be Business Process Disaster Unemployment Assistance

2 Document Control Revision History Date Version Author 12/03/ Initial Draft Rich Wilson 12/10/ Updated Template Rich Wilson 12/11/ Updating Document with Client Input Rich Wilson 12/14/ Updating Document with Client Input Rich Wilson 12/15/ Updating Document with Client Input Rich Wilson 12/22/ Updating Document for Claims Eligibility Sub-Process Rich Wilson 12/23/ Added General Assumptions Section Rich Wilson 12/23/ Updating Document with Client Input Rich Wilson 01/10/ Updating Document following Workshop Rich Wilson 01/13/ Updating Document following QA Rich Wilson 02/01/ Approved. Deniz Franck Quality Review History Date Reviewer Comments 01/13/2009 Tad McDonald Page i

3 Table of Contents 0. TO-BE PROCESS DISASTER UNEMPLOYMENT ASSISTANCE OVERVIEW ASSUMPTIONS WORKFLOW DIAGRAM TO-BE SUB-PROCESS DUA MOBILIZATION OVERVIEW WORKFLOW DIAGRAM ACTIVITIES CORRESPONDENCE PERFORMANCE METRICS BUSINESS RULES TIME CONSTRAINTS TO-BE SUB-PROCESS DUA ELIGIBILITY DETERMINATION OVERVIEW WORKFLOW DIAGRAM ACTIVITIES CORRESPONDENCE PERFORMANCE METRICS BUSINESS RULES TIME CONSTRAINTS Page ii

4 0. TO-BE PROCESS DISASTER UNEMPLOYMENT ASSISTANCE 0.1. OVERVIEW The Disaster Unemployment Assistance (DUA) program provides unemployment compensation and reemployment assistance to eligible recipients (including the self-employed) who have lost employment as a direct consequence of a major disaster. DUA is always associated with an Individual Assistance Declaration issued by the President of the United States, and is unavailable until such Declaration is received by the Florida Agency for Workforce Innovation (AWI). Each Declaration is specific to one particular disaster, and opens a claims-filing window to affected workers in specified counties. To be eligible for these benefits, claimants must meet special eligibility requirements pertaining to their loss of employment (or self-employment) and proof of income. Certain As-Is DUA processes occur outside of the Unemployment Compensation Claims and Benefits Information System (UCCBIS). These include the processes of applying for, receiving, and amending the Individual Assistance Declaration, as well as the administrative finance processes. Beyond the DUA-specific eligibility criteria, a DUA claim will be processed much like any other claim for unemployment compensation. This process does not address functionality held in common with other unemployment compensation process flows. This core process has two sub-processes. 1. Disaster Unemployment Assistance: DUA Mobilization This sub-process addresses the work necessary to implement the President s Individual Assistance Declaration following a major disaster. Some matters relating to DUA-specific claims (filing claims, certifications of weeks, etc.) are addressed in other core processes. 2. Disaster Unemployment Assistance: DUA Eligibility Determination This sub-process addresses the work necessary to make final determinations when a Claimant submits a DUA claim. Matters relating to gathering the common claims and claimant data, to processing certifications for payments, and to recovering overpayments are addressed in other core processes ASSUMPTIONS This section lists any assumptions concerning technology, policy, statute, or process that must be implemented to enable the To-Be processes: The system will include a workflow engine used to create work items, manage work queues, and route work items between queues in accordance with defined rules. Generic work queues will be established, as appropriate, to support the processing of unknown, misrouted, or incomplete work items. The system will include clearly defined roles and authorities for all users; every user will be assigned to a specific role. The system will include Case and Intake Management functionality to manage related work components and artifacts. All incoming and outgoing correspondence will be indexed and available on-line in electronic format. Page 1

5 Employers, Claimants, and authorized third-parties will have system accounts, protected by appropriate security credentials, and all work items will be associated to those accounts. The system will maintain balances for all accounts and automatically recalculate balances based on the reversal or modification of prior actions. Claimants, Employers, and authorized third-parties will be able to opt for electronic communication. will be an optional communication method for external parties (claimants, employers, and authorized third-parties). Communication will be in accordance with the preferred method (e.g., notifications, fax, and paper). The system will not send sensitive information via . Users will be notified documents are ready to be viewed using their online accounts. Access to documents will be controlled using appropriate security credentials. All claims, claim weeks, determinations, and payments will be traceable to funding sources and employer chargeability records. The system will create and maintain an online history of all activities related to a particular claimant, employer, or authorized third-party to include claims, claim weeks, determinations, and decisions WORKFLOW DIAGRAM Exhibit 1 Disaster Unemployment Assistance Core Process Workflow Diagram Page 2

6 1. TO-BE SUB-PROCESS DUA MOBILIZATION 1.1. OVERVIEW After a major disaster, and upon request of the Governor, the President of the United States may issue an Individual Assistance Declaration. This Declaration will provide federal funding to assist those workers who lose employment as a direct consequence of the disaster. The DUA Mobilization Sub-Process addresses actions AWI must take in preparation for the anticipated DUA-related unemployment compensation claims. Dates must be established within the system in order to determine appropriate and related time-frames for claims, benefits, reports, etc. Press releases and other documents must be prepared for appropriate distribution. Reporting structures must be initialized. Potential DUA claimants must be notified of the existence of these potential benefits. The basic templates for all these actions will be available within the system. This sub-process addresses the initialization and activation of these activities. The objectives of this sub-process include: Completing all necessary non-financial tasks in preparation for taking DUA claims following the receipt of an Individual Assistance Declaration by the President of the United States. Beginning Points: The DUA Administrator receives the President s Individual Assistance Declaration. Ending Points: DUA Late Claims Functionality closes at the end of the Disaster Assistance Period (DAP). Assumptions specific to this sub-process include: All activities specific to the issuing of the Individual Assistance Declaration occur prior to DUA Mobilization and outside of the Unemployment Compensation Claims and Benefits Information System (UCCBIS). All activities relating to the financial administration of any disaster-specific Declaration of Individual Assistance will occur outside of the system and are not addressed in this DUA Core Process. Page 3

7 1.2. WORKFLOW DIAGRAM Exhibit 2 DUA Mobilization Workflow Diagram Page 4

8 1.3. ACTIVITIES The table below lists the activities that make up this process. The following is a description and definition of each of the columns in this table. Index Activity Label System Activity Actor Activity Actor(s) A number for use in referencing the activity. A short name for that activity that is used to represent it in the detailed workflow diagram. The full-text description of that activity from the perspective of the system. The full-text description of that activity from the perspective of the user or actor. The job or role title of the individuals having a primary role for that activity. Index Activity Label System Activity Enter Disaster Details Prepare Press Releases The system will Save the Disaster Details as entered by the DUA Administrator or Designee Allow the Disaster Details to be edited Notify the DUA Administrator or Designee of any missing Disaster Details other than Initial Press Release Publication Date. When the DUA Administrator activates the DUA Claims Options (which exist in the UCCBIS in a dormant state), the system will undertake the following activities: Initialize Reporting Structures, Initialize DUA Claims Functionality, and Send DUA BRI s to Straight DUA Claimants. The system will prepare both the Initializing Press Release and the Closing Press Release from existing templates by populating them with the appropriate Disaster Details. If review is required, the system will place the Press Releases in the AWI Communications work queue. The next activity is Review Press Releases. If no review is required, The next activity is Publish Initializing Press Release. Actor Activity The DUA Administrator will enter all Disaster Details except for the Publication Date of the Initializing Press Release into the system. If deemed necessary for the timely acceptance of claims, the DUA Administrator may Activate DUA Claims Options at any point in this flow after Enter Disaster Details. The next activity is Prepare Press Releases. - - Actor(s) DUA Administrator, DUA Administrator s Designee Page 5

9 Index Activity Label System Activity Review Press Releases Publish Initializing Press Release Prepare DUA Fact Sheet The system will store any edits AWI Communications may make to the Press Releases publish the edited Press Releases at the appropriate times If no review by AWI Communications is required, the system will publish the Initializing Press Release to the appropriate media outlet(s). When the Initializing Press Release is published, the system will add the date the Initializing Press Release is published to the Disaster Details start the 30 day clock for the window for the initial DUA claims filing period start the 21 day clock for publishing the Closing Press Release. The system will prepare the DUA Fact Sheet from existing templates by populating them with the appropriate Disaster Details store the DUA Fact Sheet in preparation for publication The next activity is Prepare Interstate Coordinator s Announcement. Actor Activity If required, AWI Communications will edit and refine the system-prepared Press Releases. The next activity is Publish Initializing Press Release. If review by AWI Communications is required, AWI Communications will authorize the system to publish the Initializing Press Release to the appropriate media outlet(s). When the Initializing Press Release is published, the next activity is the group of activities: Prepare DUA Fact Sheet, Prepare Interstate Coordinator s Announcement, Prepare Interim Procedural Instructions. When the 21 day clock for publishing the Closing Press Release expires, the next activity is Publish Closing Press Release. - - Actor(s) AWI Communications AWI Communications Page 6

10 Index Activity Label System Activity Prepare Interstate Coordinator s Announcement Prepare Interim Procedural Instructions Publish Prepared Documents The system will prepare the Interstate Coordinator s Announcement from existing templates by populating them with the appropriate Disaster Details store the Interstate Coordinator s Announcement in preparation for publication The next activity is Prepare Interim Procedural Instructions. The system will prepare the Interim Procedural Instructions from existing templates by populating them with the appropriate Disaster Details store the Interim Procedural Instructions in preparation for publication place the Interim Procedural Instructions in the Reviewer s queue for review The next activities are Review Interim Procedural Instructions and Publish Prepared Documents. The system will publish the following prepared documents to the appropriate recipients after populating them with the Disaster Details: DUA Fact Sheet Interstate Coordinator s Announcement Interim Procedural Instructions The next activity is Activate DUA Claims Options. Actor Activity Actor(s) Page 7

11 Index Activity Label System Activity Activate DUA Claims Options Initialize Reporting Structures When the DUA Administrator activates the DUA Claims Options (which exist in the UCCBIS in a dormant state), the system will undertake the following activities: Initialize Reporting Structures, Initialize DUA Claims Functionality, and Send DUA BRI s to Straight DUA Claimants. The system will allow the DUA Administrator s Designee to create and/or modify Ad-Hoc Reports as needed throughout the life of the disaster response effort. Through the life of the disaster response effort, the system will populate existing reports templates with appropriate data and the Disaster Details, and will distribute them as follows: ETA 90-2 Monthly Recap, which it will send to the US Department of Labor and to the US Department of Homeland Security DARIS Weekly Cumulative Report, which it will send to the US Department of Labor, the US Department of Homeland Security, and others as may be required Ad-Hoc Reports, which it will place in the appropriate queue for review and refinement as necessary. The next activity is Initialize DUA Claims Functionality. Actor Activity The DUA Administrator will activate the system s DUA Claims Options functionality. Activation of the DUA Claims Options functionality is not dependent upon the completion of any prior activities other than Enter Disaster Details. If deemed necessary for the timely acceptance of claims, the DUA Administrator may Activate DUA Claims Options at any point in this flow after entering the Disaster Details. The work flow branches. One of the next activities is Initialize Reporting Structures. The other next activity is Send DUA BRI s to Straight DUA Claimants. The DUA Administrator s Designee will create and/or modify Ad-Hoc Reports as needed throughout the life of the disaster response effort. The next activity is Initialize DUA Claims Functionality. Actor(s) DUA Administrator DUA Administrator s Designee Page 8

12 Index Activity Label System Activity Initialize DUA Claims Functionality Send DUA BRI s to Straight DUA Claimants Review Interim Procedural Instructions Publish Finalized Procedural Instructions Publish Closing Press Release The system will activate functionality to permit the filing and processing of DUA Claims. DUA claims-taking options (which exist in the UCCBIS in a dormant state) become active and available in all portals to the system. This work flow branch ends with a link to Claims. The next activity is Send DUA BRI s to Straight DUA Claimants. The system will send DUA Benefits Rights Information (BRI) notices to DUA claimants, explaining eligibility requirements and the determinations process. The next activity is Review Interim Procedural Instructions. The system will store the reviewed Interim Procedural Instructions as the Finalized Procedural Instructions. The system will distribute the Finalized Procedural Instructions to the appropriate Recipients. 21 days after publishing the Initializing Press Release, the system will publish the Closing Press Release (which has already received any required review and refinement) to the appropriate media outlet(s). The next activity is Initialize DUA Late Claims Functionality. Actor Activity If required, the Reviewer will review and/or edit the Interim Procedural Instructions with special attention to adjudication and call center details. The next activity is Publish Finalized Procedural Instructions. The Interim Procedural Instructions will become the Finalized Procedural Instructions after the Reviewer refines the system-prepared Interim Procedural Instructions. When finalized, the Reviewer will publish the Finalized Procedural Instructions. The next activity is Publish Closing Press Release. - - Actor(s) Reviewer Reviewer Page 9

13 Index Activity Label System Activity Initialize DUA Late Claims Functionality 30 days after publishing the Initializing Press Release, the system will activate DUA Late Claims Functionality which will require the user to provide justification for filing after the 30 day DUA Initial Claims Functionality window has closed. 26 weeks after the Initializing Press Release was published, the DAP ends and the window for DUA Late Claims with Justification closes. The process ends. Actor Activity - - Actor(s) 1.4. CORRESPONDENCE The table below lists any messages, such as the US mail, s, faxes, phone calls and any other correspondence, regularly used in the normal course of this process. Note: The system will provide a self-service portal to allow users (claimants and employers) to opt in to electronic delivery of documents (e.g., messages, notices, and other correspondence). Documents will not be sent to users who elect electronic communications, rather, notifications will be issued to inform users they have documents available for review. A user will log on to the system using their unique security credentials (created when they initially set up their online account) to read the documents and will then undertake appropriate action(s). Unless otherwise precluded by law, any message listed in the following table may be delivered via the self-service portal once a user opts in for electronic delivery. Messages are sent to convey required documentation, inform recipients about the status of an activity, to trigger the start or end of other activities, to grant or withdraw authorization, etc. This section only concerns messages sent during normal (as intended) operations. There may be more than one message associated with any activity in this process. The following is a description and definition of each of the columns in this table. Index Activity Label Type Purpose Recipient Occasion A number for use in referencing the activity. A short name for that activity that is used to represent it in the detailed workflow diagram. Form An official request for specific information based in a pre-defined format. Notice Notice of an official Agency action or determination. Ad-Hoc Requests for information, responses, and general communications. Normally used to validate or complete existing records. Memo - Internal communication for the purpose of sharing information. The intended purpose for sending the message. The organization or role of the intended recipient. Event or action that triggers the requirement to send the message. Page 10

14 Index Activity Label Type Purpose Recipient Occasion Publish Initializing Notice Media Press Release Publish Initializing Press Release Publish Prepared Documents Publish Prepared Documents Publish Prepared Documents Send DUA BRIs to Straight DUA Claimants Publish Finalized Procedural Instructions Publish Closing Press Release Memo Memo Memo Memo Notice Memo Notice Announces the activation of DUA claims functionality, and establishes the start date ( Announcement Date ) for the 30 day DUA claims taking period. Adds the Initializing Press Release Date of Publication to the previously-entered Disaster Details. This establishes the start date for the 30 day DUA claims taking period. DUA Fact Sheet provides essential data for working DUA claims, including making determinations. Interstate Coordinator s Announcement notifies unemployment compensation agencies in other states of the availability of DUA in Florida, for which some of their claimants may qualify. Interim Procedural Instructions provides UC Program Managers with instructions and data necessary to manage DUA claims work and related issues. Provides DUA claimants with explanations of eligibility requirements and the determinations process. Provides UC Program Managers with instructions and data necessary to manage DUA claims work and related issues. Provides advance notice that the window for submitting DUA claims is closing. DUA Administrator s Designee Recipients: Internal and External Recipients: UC Coordinators in states other than Florida Recipients: AWI UC Program Managers Potential DUA Claimants Recipients: AWI UC Program Managers Media All DUA claims functionality is being activated, and AWI is announcing details related to filing DUA claims. Initializing Press Release has been published. DUA Fact Sheet is fully and properly populated with current Disaster Details. Interstate Coordinator s Announcement is fully and properly populated with current Disaster Details. Interim Procedural Instructions are fully and properly populated with current Disaster Details. DUA functionality is activated in the system. Finalized Procedural Instructions have been appropriately reviewed. 21 days have passed since the Initializing Press Release was published PERFORMANCE METRICS The table below lists any performance metrics that may be used to measure the outcome, accuracy or efficiency of this process. Page 11

15 Title Metric Target Source A description of the metric Complete description of the performance measure Goal or Target to expected or N/A if not applicable The performance metric source (Florida Statutes, AWI policy, etc.). Title Metric Target Source Press Release Timeliness Claims Activation Timeliness First Claim Timeliness First Payment Timeliness Procedural Instructions Timeliness Elapsed time from Enter Disaster Details to Publish Initializing Press Release. Elapsed time from Enter Disaster Details to Activate DUA Claims Option. Elapsed time from Enter Disaster Details to the acceptance of the first DUA claim. Elapsed time from Enter Disaster Details to the payment of the first DUA claim. Elapsed time from Enter Disaster Details to Publish Finalized Procedural Instructions. To be To be To be To be To be AWI Policy AWI Policy AWI Policy AWI Policy AWI Policy 1.6. BUSINESS RULES The table below lists any statutes or policies that govern the execution of this process. These business rules may be executed by the system or the user. The following is a description and definition of each of the columns in this table. Number Conflict Number Conflict The unique number assigned to the business rule. Y(Yes) if the current Statute, Administrative Code, or AWI Policy conflicts with the to-be process or N (No) if the current Statute, Administrative Code, or AWI Policy does not conflict with the to-be process. A full-text description of the business rule. BR N (3) 4 FS: DUA benefits are not charged to the employer of record. BR N 42 U.S.C et seq.: Robert T. Stafford Disaster Relief and Emergency Assistance Act (PL ). BR N 20 CFR 625.6: Details the appropriate DUA weekly amount; jurisdictions; reductions. BR N 20 CFR (a)(2): The base period to be utilized in computing the DUA weekly amount. BR N 20 CFR 625.8(a) Specifies the 30 day window for filing a claim for DUA, but also permits late filing providing the claimant can show good cause for late filing. BR N 20 CFR 625.8(f): Defines the Disaster Assistance Period as the period beginning with the first week following the date the major disaster began, and ending with the 26 th week subsequent to the date the major disaster was declared. BR N 42 U.S.C et seq. (Robert T. Stafford Disaster Relief and Emergency Assistance Act): BR N (3)4 FS: When an individual is separated from work as a direct result of a natural disaster declared under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. ss et seq., benefits subsequently paid to the individual based on wages paid by the employer before the separation may not be charged to the employment record of the employer. Page 12

16 Number Conflict BR N 42 U.S.C. 5189b Date of Eligibility; Expenses incurred before Date of Disaster: Eligibility for Federal assistance under this title shall begin on the date of the occurrence of the event which results in a declaration by the President that a major disaster exists, except that reasonable expenses which are incurred in anticipation of and immediately preceding such event may be eligible for Federal assistance under this Act TIME CONSTRAINTS The table below lists any time constraints that are placed on activities within this process. Time constraints may be required completion times or required pauses in the process to allow for responses. The following is a description and definition of each of the columns in this table. Index Activity Label Source Constraint A number for use in referencing the activity. A short name for that activity that is used to represent it in the detailed workflow diagram. The source of the constraint (Florida Statutes, AWI policy, etc.). A full-text description of the constraint. Index Activity Label Source Constraint Publish Initial Press Release Publish Initial Press Release Publish Initial Press Release 20 CFR 625.8(a) The Initial Press Release publication date begins the 30 day clock for filing DUA Claims. After 30 days, DUA Claims applicants must provide acceptable good cause justification for filing DUA Claims. AWI Policy AWI Policy The Initial Press Release publication date begins the 21 day clock to the date for publishing the Closing Press Release. The Initial Press Release publication date begins the 26 week Disaster Assistance Period (DAP). Page 13

17 2. TO-BE SUB-PROCESS DUA ELIGIBILITY DETERMINATION 2.1. OVERVIEW After a major disaster, and upon request of the Governor, the President of the United States may issue an Individual Assistance Declaration. This Declaration will provide federal funding to assist those workers who lose employment as a direct consequence of the disaster. DUA claims taking functionality exists in the system in a dormant state until activated during the DUA Mobilization sub-process. Once the DUA claims options are activated, qualified claimants may apply for this assistance during the initial period of 30 days. With appropriate justification, claimants may apply at any time during the entire 26 weeks of the Disaster Assistance Period (DAP). Claimants begin the application process with the normal claims-filing activities (which are addressed in the Claims Core Process). This DUA Eligibility Determination sub-process addresses the activities necessary to reach a final determination regarding a Claimant s request for Disaster Unemployment Assistance. The objectives of this sub-process include: Completing all necessary tasks to make a final determination regarding a Claimant s application for Disaster Unemployment Assistance (DUA). Beginning Points: The Claims: Submit Application link activates because a Claimant s application, which does not qualify for unemployment compensation under any other assistance program, may qualify for DUA. Ending Points: A Claimant s application for DUA has been disqualified because it was not filed timely, or the Claimant offered inadequate justification for filing a late DUA claim, or the Claimant did not meet Employment Loss Criteria. A Claimant s application for DUA has been approved for payments because the Claimant filed an appropriate application, and the Claimant provided adequate proof of employment/wages lost as a direct result of the disaster within the 21 day window for providing such proof. A Claimant s application for DUA has been disapproved and the claim referred to Benefit Payment Control to recover benefits already paid under a Determination Pending Proof. The Claimant s application was approved and benefits paid pending the Claimant providing adequate proof of employment/wages lost as a direct result of the disaster, which the Claimant failed to provide. Assumptions specific to the DUA Eligibility Determination Sub-Process include: All non-dua-specific claims-taking activities (including gathering the Claimant s demographics, claims history, etc.) occur outside of this sub-process. Page 14

18 2.2. WORKFLOW DIAGRAM Exhibit 3 DUA Eligibility Determination Workflow Diagram Page 15

19 2.3. ACTIVITIES The table below lists the activities that make up this process. The following is a description and definition of each of the columns in this table. Index Activity Label System Activity Actor Activity Actor(s) A number for use in referencing the activity. A short name for that activity that is used to represent it in the detailed workflow diagram. The full-text description of that activity from the perspective of the system. The full-text description of that activity from the perspective of the user or actor. The job or role title of the individuals having a primary role for that activity. Index Activity Label System Activity Select DUA Claim Application The system will select a DUA Claim Application from its queue. Where possible, if (a) the Claimant seeks to qualify under the loss of employment promised to begin on the date of the disaster, and (b) appropriate documentation of said promise of employment is not already in the system, then the system will require the Claimant to complete such documentation prior to further consideration of the claim. The next activity is to return the Claim Application to the queue. When the Claimant provides such documentation, the system will resume processing with this activity. The system will ascertain whether or not the initial 30 day window for filing DUA claims is still open. If either claims filing window is open, the system will place the claim in the appropriate DUA Claims Processor s work queue. If the window is open, the next activity is Evaluate Employment Loss Criteria. If the window is closed, the next activity is Evaluate Late Filing Justification. Actor Activity - - Actor(s) Page 16

20 Index Activity Label System Activity Evaluate Late Filing Justification Evaluate Employment Loss Criteria The system will present the DUA Claims Processor with an appropriate list of selectable claims. The system will present the DUA Claims Processor with an appropriate list of selectable claims. Actor Activity The DUA Claims Processor will select a claim from the list. All claims filed after the 30 day window for timely claims filing closes must include acceptable Late Filing Justification. If the Claimant provides Proof after the Proof Window closes, the claim is treated as late-filed and it re-enters the process from Evaluate for Proof & Proof Window. The DUA Claims Processor will review Claimant s Late Filing Justification. If Justification is acceptable, the next activity is Meets Employment Loss Criteria. If Justification is unacceptable, the DUA Claims Processor will deny the claim and issue a Disqualification. In this event, the process ends. The DUA Claims Processor will select a claim from the list. DUA Claims Processor will ascertain whether or not the claim meets the Employment Loss Criteria. If the claim meets the Employment Loss Criteria, the next activity is Evaluate for Proof & Proof Window. If the claim does not meet the Employment Loss Criteria, the DUA Claims Processor will deny the claim and issue a Disqualification. In this event, the process ends. Actor(s) DUA Claims Processor DUA Claims Processor Page 17

21 Index Activity Label System Activity Evaluate for Proof and Proof Window Issue Determination Pending Proof The system will present the DUA Claims Processor with an appropriate list of selectable claims. If Proof is deficient and Proof Window is open, the system will store that action and will issue a DUA Monetary Determination Pending Proof, and will link to the Issue Payments process. The system will send the Claimant a notice to provide acceptable proof of employment/wages. The next activity is Provide Earnings Proof. Actor Activity The DUA Claims Processor will select a claim from the list. DUA Claims Processer will review Claimant s proof of employment / wages for DUA acceptability. If Proof is deficient and the Proof Window is open, the DUA Claims Processor will place the claim in the appropriate work queue. The next activity is Issue Determination Pending Proof. If Proof is deficient and Proof Window is closed, the DUA Claims Processor will place the claim in the appropriate work queue. The next activity is Redetermine & Establish Overpayment. If Proof is accepted and Proof Window is open, the DUA Claims Processor will place the claim in the appropriate work queue. The next activity is Issue Determination / Redetermination. Note: If the Claimant provides Proof after the Proof Window closes, the DUA Claims Processor will place the claim in the appropriate work queue. The next activity is link to Evaluate Late Filing Justification. - - Actor(s) DUA Claims Processor Page 18

22 Index Activity Label System Activity Provide Earnings Proof Issue Redetermination & Establish Overpayment Issue Determination / Redetermination Actor Activity - The Claimant must provide acceptable proof of employment/wages within 21 days of filing a claim for DUA unemployment compensation. After the DUA Claims Processor makes the DUA Monetary Redetermination and Establishes Overpayment, the system will store that action and will notify Benefit Payment Control for collection. The process ends with a link to Benefit Payment Control. After the DUA Claims Processor makes a DUA Monetary Determination / Redetermination, the system will store that action and will link to Issue Payments. When the Claimant provides proof, the next activity is Evaluate for Proof and Proof Window. If Claimant was issued a DUA Monetary Determination Pending Proof of employment/wages, and does not provide acceptable proof within 21 days of filing the claim for DUA unemployment compensation, the DUA Claims Processor will make a DUA Monetary Redetermination and Establish Overpayment. The process ends with a link to Benefit Payment Control. If the Claimant provided acceptable Proof of Employment/Wages when filing the claim, the DUA Claims Processor will issue a DUA Monetary Determination for the appropriate amount. If the Claimant provides acceptable Proof of Employment/Wages after a DUA Monetary Determination Pending Proof was issued, the DUA Claims Processor will issue a Redetermination for the appropriate amount. The process ends with a link to Issue Payments. Actor(s) Claimant DUA Claims Processor DUA Claims Processor 2.4. CORRESPONDENCE The table below lists any messages, such as the US mail, s, faxes, phone calls and any other correspondence, regularly used in the normal course of this process. Note: The system will provide a self-service portal to allow users (claimants and employers) to opt in to electronic delivery of documents (e.g., messages, notices, and other correspondence). Documents will not be sent to users who elect electronic communications, rather, notifications will be issued to inform users they have documents available for review. A user will log on to the system using their unique security credentials (created when they initially set up their online account) to read the documents and will then undertake appropriate action(s). Unless otherwise precluded by law, any message listed in the following table may be delivered via the self-service portal once a user opts in for electronic delivery. Page 19

23 Messages are sent to convey required documentation, inform recipients about the status of an activity, to trigger the start or end of other activities, to grant or withdraw authorization, etc. This section only concerns messages sent during normal (as intended) operations. There may be more than one message associated with any activity in this process. The following is a description and definition of each of the columns in this table. Index Activity Label Type Purpose Recipient Occasion A number for use in referencing the activity. A short name for that activity that is used to represent it in the detailed workflow diagram. Form An official request for specific information based in a pre-defined format. Notice Notice of an official Agency action or determination. Ad-Hoc Requests for information, responses, and general communications. Normally used to validate or complete existing records. Memo - Internal communication for the purpose of sharing information. The intended purpose for sending the message. The organization or role of the intended recipient. Event or action that triggers the requirement to send the message. Index Activity Label Type Purpose Recipient Occasion Select DUA Claim Form Claimant Application Evaluate Late Filing Justification Evaluate Employment Loss Criteria Issue Determination Pending Proof Provide Earnings Proof Notice Notice Form Ad-Hoc To request appropriate documentation of Proof of Promise of Employment. To inform the Claimant that the application for DUA has been denied and a Disqualification has been issued. To inform the Claimant that the application for DUA has been denied and a Disqualification has been issued. To request the Claimant provide acceptable proof of employment/wages. To provide acceptable proof of employment/wages. Claimant Claimant Claimant DUA Claims Processor Claimant alleges disaster-caused loss of employment promised to begin on the date of the disaster, but has not provided appropriate Proof of Promise of Employment. Claimant does not provide acceptable Late Filing Justification. Claimant does not meet Employment Loss Criteria. Claimant has not provided acceptable proof of employment/wages, and the 21 day window is still open for providing such proof. Claimant is attempting to provide acceptable proof of employment/wages PERFORMANCE METRICS The table below lists any performance metrics that may be used to measure the outcome, accuracy or Page 20

24 efficiency of this process. Title Metric Target Source A description of the metric Complete description of the performance measure Goal or Target to expected or N/A if not applicable The performance metric source (Florida Statutes, AWI policy, etc.). Title Metric Target Source DUA Related Claims Diversion Claims Estimate Accuracy The number of DUA Related Claims diverted to non-dua UC. The pre-dap estimated number of DUA claims vs. the actual number of DUA claims. To be To be DUA Claims The daily count of total DUA claims by county. To be DUA-Related Claims The daily count of DUA-related claims by county. To be DUA-Only Claims The daily count of DUA-only claims by county. To be DUA Claims Applications DUA Claims by Employment DUA Claims Eligible DUA Claims Overpayments Number of Applications Expected vs. Number of Applications Received vs. Number of Applications Approved vs. Number of Applications Disbursed vs. Number of Applications Withdrawn or Disapproved The total number of claims filed by self-employed claimants vs. the total number of claims filed by other claimants. The total number of claims determined eligible, broken out by self-employed claimants and other claimants. The total number of claims resulting in overpayments. To be To be To be To be - DARIS Report DARIS Report DARIS Report DARIS Report DUA RESPONSIBILITIE S 8-08.doc DUA RESPONSIBILITIE S 8-08.doc DUA RESPONSIBILITIE S 8-08.doc DUA RESPONSIBILITIE S 8-08.doc 2.6. BUSINESS RULES The table below lists any statutes or policies that govern the execution of this process. These business rules may be executed by the system or the user. The following is a description and definition of each of the columns in this table. Number Conflict Number Conflict The unique number assigned to the business rule. Y(Yes) if the current Statute, Administrative Code, or AWI Policy conflicts with the to-be process or N (No) if the current Statute, Administrative Code, or AWI Policy does not conflict with the to-be process. A full-text description of the business rule. BR N (3) 4 FS: DUA benefits are not charged to the employer of record. BR N 42 U.S.C et seq.: Robert T. Stafford Disaster Relief and Emergency Assistance Act (PL ). BR N 20 CFR 625.6: Details the appropriate DUA weekly amount; jurisdictions; reductions. BR N 20 CFR (a)(2): The base period to be utilized in computing the DUA weekly amount. BR N 20 CFR 625.8(a) Specifies the 30 day window for filing a claim for DUA, but also permits late filing providing the claimant can show good cause for late filing. Page 21

25 Number Conflict BR N 20 CFR 625.8(f): Defines the Disaster Assistance Period as the period beginning with the first week following the date the major disaster began, and ending with the 26 th week subsequent to the date the major disaster was declared. BR N 42 U.S.C et seq. (Robert T. Stafford Disaster Relief and Emergency Assistance Act): BR N (3)4 FS: When an individual is separated from work as a direct result of a natural disaster declared under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. ss et seq., benefits subsequently paid to the individual based on wages paid by the employer before the separation may not be charged to the employment record of the employer. BR N 42 U.S.C. 5189b Date of Eligibility; Expenses incurred before Date of Disaster: Eligibility for Federal assistance under this title shall begin on the date of the occurrence of the event which results in a declaration by the President that a major disaster exists, except that reasonable expenses which are incurred in anticipation of and immediately preceding such event may be eligible for Federal assistance under this Act TIME CONSTRAINTS The table below lists any time constraints that are placed on activities within this process. Time constraints may be required completion times or required pauses in the process to allow for responses. The following is a description and definition of each of the columns in this table. Index Activity Label Source Constraint A number for use in referencing the activity. A short name for that activity that is used to represent it in the detailed workflow diagram. The source of the constraint (Florida Statutes, AWI policy, etc.). A full-text description of the constraint. Index Activity Label Source Constraint Select DUA Claim Application Select DUA Claim Application Select DUA Claim Application 20 CFR 625.8(a) and AWI Policy 20 CFR 625.8(a) and AWI Policy 20 CFR 625.8(a) and AWI Policy 30 Day Timely Filing Window: Claimants have 30 days from the date of the Initializing Press Release during DUA Mobilization to file timely claims for Disaster Unemployment Assistance. While this constraint is included in the DUA Mobilization Sub-Process, it is noted here for its significance to the present sub-process as well. 21 Day Proof of Employment/Wages Window: Claimants must provide acceptable proof of employment/wages within 21 days of filing the claim for Disaster Unemployment Assistance. If the Claimant provides Proof after the Proof Window closes, the claim is treated as late-filed. While this constraint should be included in the broader Claims Process, it is noted here for its significance to the present subprocess as well. 26 Week Late Filing with Justification: Claimants may late-file claims for Disaster Unemployment Assistance after the 30 Day Timely Filing Window closes if they provide acceptable justification prior to the close of the 26 week Disaster Assistance Period (DAP). While this constraint is included in the DUA Mobilization Sub-Process, it is noted here for its significance to the present sub-process as well. Page 22