SFHSS PeopleSoft HCM Benefits Optimization

Client Introduction

SFHSS manages benefits for over 126,000 employees, retirees, and dependents across four agencies. Facing data processing delays, reconciliation issues, and manual vendor interactions, SFHSS sought to optimize its Benefits Administration setup in PeopleSoft HCM 9.2, including HIPAA EDI generation and premium deduction accuracy.

Problem/Client Challenges

SFHSS was experiencing significant inefficiencies in its benefits administration processes. Key challenges included:

• Delayed data processing, leading to lags in member eligibility updates and benefits enrollments.

• Frequent reconciliation discrepancies between PeopleSoft HCM records and vendor systems, resulting in time-consuming manual corrections.

• Inaccurate or incomplete HIPAA EDI file generation, risking compliance issues and delayed vendor transactions.

• Manual and inconsistent interactions with multiple benefits vendors, increasing operational complexity and error rates.
  These issues collectively hindered SFHSS’s ability to maintain accurate premium deductions, meet compliance requirements, and deliver timely benefits services to its members.

Solution

• AllCode brought certified HCM consultants and integration engineers to reconfigure Benefits Administration, Deduction Calculation, and Vendor Payment processes.

• Re-architected inbound/outbound interfaces with pension systems and school district HRIS using PeopleSoft Integration Broker and SQR scripts.

• Built real-time audit dashboards using PeopleSoft Query and Oracle BI for staff to validate data prior to payroll locking.

• Deployed workflow automations for exception processing, reducing manual intervention by benefits coordinators.

• Trained 20+ SFHSS staff via remote sessions on managing OCI migration preparation and PUM updates.

Results

• Achieved a 97% User Acceptance Testing (UAT) pass rate on all implemented features.

• Reduced reconciliation efforts by over 40 hours per month.

• Enhanced compliance reporting and HIPAA EDI file accuracy.

Positioned AllCode for future OCI migration support under new task orders.