Shared Responsibility Multi-Employer Import File Specification

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Health Compliance Shared Responsibility Multi-Employer Import File Specification Creation Date: 06/12/2015 Modified Date: 09/28/2015 Version: v2.51 adp.com

Table of Contents Table of Contents... 2 Document Information... 3 Document Revisions... 3 Overview... 4 Format... 4 Multi-Employer Data Interface... 5 Frequency of Data... 5 Changes Only File... 5 Initial Load File... 5 Termination of Multi-Employer Status... 5 File Naming Convention... 5 Fields Included on the Interface... 6 Header Record (always required)... 6 Participant Identifiers (always required)... 6 Status (always required)... 7 Trailer Information (always required)... 7 Appendix... 8 2

Document Information Document Revisions Version Date Author Description 2.51 09/28/2015 Chris Murphy Initial Document 3

Overview Employee information will be provided on the HR, Benefits, Leave of Absence, and Payroll Imports. However, employees that are covered under a multi-employer arrangement may have their benefits information maintained in a different system. This document provides the specifications and information necessary for successfully loading Multi-Employer data into the ADP Health Compliance system. Format The ADP Health Compliance system will accept multi-employer data in a pipe delimited ( ) format. The multi-employer data is required in order to support regulatory management. The system requires information on employees whose medical coverage is provided through a multi-employer plan (i.e., union medical benefits where the employer contributes to a multi-employer plan). In order to process this set of data, a record type is required on each record. The record type will identify the type of data included on that particular record. The following record types are supported for the Multi-Employer interface: HEAD = The header record for the file. This record is used to identify the client. EEID = The identity record for the participant. STAT = The multi-employer status for the employee. FOOT = The footer record for the file. 4

Multi-Employer Data Interface Frequency of Data In order to perform accurate eligibility and affordability calculations, as well as annual filings, it is very important that the ADP Health Compliance system is up to date with the multi-employer data. It is expected that the source system would provide data to the ADP Health Compliance system least a monthly basis. Changes Only File It is expected that on an ongoing basis the source system will provide only employees that experienced a change to their multi-employer status. If an employee is included on the changes only file, all data elements for that employee should be included on the file, not just the changed elements. Initial Load File During implementation, the ADP Health Compliance system requires initial multi-employer status dating back to the beginning of the medical plan year, typically Annual Enrollment. Subsequent changes in status up to the date of go-live are also to be included on the initial load. Termination of Multi-Employer Status If an employer is no longer contributing to a multi-employer plan for the employee and the multiemployer status was previously reported to the ADP Health Compliance system, a record should be included to indicate the employee no longer belongs to a multi-employer plan. File Naming Convention The Multi-Employer Import file should be sent to ADP utilizing the following file naming convention: <COID>_<NETSECUREID>_MultiER_YYYYMMDD_HHMMSS.txt Example: 0R8JLMSFMN04078L_COMPANYABC_MultiER_20150617_124532.txt NOTE NetSecure ID is a case sensitive unique, different than the COID. Both the NetSecure ID and COID shall be provided to the client/vendor by ADP. The date time stamp represents the date and time the file was created. 5

Fields Included on the Interface Header Record (always required) Field Field Required/Optional Maximum Notes Number Field Length 1. Record Type Required 4 Constant HEAD 2. Organization OID (COID) Required 16 The 16 character company GUID assigned by ADP. 3. Client Name Required 100 Participant Identifiers (always required) Field Field Required/Optional Maximum Notes Number Field Length 1. Record Type Required 4 Constant EEID 2. Participant SSN Required 11 Format: XXX-XX-XXXX Or XXXXXXXXX 3. Participant First Name 4. Participant Middle Name 5. Participant Last Name Required 50 Optional 50 Required 50 The SSN for the participant that will be maintained within the ADP Health Compliance system. 6

Status (always required) Field Number Field Required/Optional Maximum Field Length Notes 1. Record Type Required 4 Constant STAT 2. Participant SSN Required 11 Format: XXX-XX-XXXX Or XXXXXXXXX 3. Multi-Employer Status 4. Status Effective Date The SSN for the participant that will be maintained within the ADP Health Compliance system. Required 1 Valid Values: Y = Yes (Employee belongs to a multi-employer plan) N = No (Employee does not belong to a multi-employer plan) For the employee to belong to a multi-employer plan, the employer must be contributing to the plan on behalf of the employee. Required 10 Format: MM/DD/CCYY The date the Multi-Employer Status first became effective. Trailer Information (always required) Field Field Required/Optional Maximum Notes Number Field Length 1. Record Type Required 4 Constant FOOT 2. Number of EEID Records Required 6 The total number of EEID records included on the file. 7

Appendix Sample Data HEAD 0R8JLMSFMN04078L Test Client EEID 999-99-9901 STEVE K DOE STAT 999-99-9901 Y 01/01/2015 FOOT 1 8