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Strategic Objective
SG07.02 Advance the 21st century customer-focused retirement processing system for claims adjudication in a timely and accurate manner
Strategic Objective
Overview
- Investing in information technology tools and solutions such as the development of a full case management and workflow capability to facilitate payment of accurate and timely benefits payments.
- Using performance measures to ensure quality customer service.
- Strengthening quality assurance processes, policies, and procedures.
- Ensuring continued focus on addressing and reducing improper payments.
- Using all tools available including the CARE Team, the LAS survey and the Customer Service Survey to identify customer service trends and prioritize areas where change is needed
- Delivering optimal customer service experiences by improving processes.
- Implementing best practices for receipt and use of electronic data.
- Issuing data standards for agencies and payroll providers and investing in the capability to receive data in appropriate standards.
- Issuing data standards for electronic application.
Progress Update
OPM continues to implement the core components in the Retirement Services Strategic Plan, including delivering quality customer service to people; implementing productivity and process improvements; partnering with agencies; and making partial, progressive information technology improvements. When the Retirement Services Strategic Plan was released in January 2012, the inventory was 61,108 claims. As of the end of FY 2015, OPM had reduced the inventory to 14,706. The agency’s FY 2015 processing accuracy has remained stable at 94 percent.
OPM is focused on both its internal process improvements and external outreach towards other Federal agencies to meet its goal of processing 90 percent of claims within 60 days. Based on a Lean Six Sigma process improvement review, OPM has streamlined and standardized workflows, for example, changing processes to review and assemble complete cases before distributing them to legal administrative specialists for adjudication. As of the end of FY 2015, all pending processing claims were processed within an average of 56.2 days, with 70 percent processed within 60 days.
OPM typically receives a surge of retirement claims at the beginning of the calendar year. In FY 2015, the surge included approximately 30,000 new claims, exceeding projections. In previous years, OPM has hired additional staff at the beginning of the fiscal year to offset the increased workload. Due to resource constraints, OPM was not able to use this approach in FY 2015.
As these claims hit their 60 day mark around April, OPM’s 60 day processing percentage decreased. The table below shows the 60 day processing goal broken out by month, showing the impact from the surge and the increased progress since April. By monitoring this goal on a monthly basis, OPM anticipates fine tuning the process.
Month |
Percent Processed in 60 days |
October 2014 |
83.2% |
November 2014 |
83.7% |
December 2014 |
84.4% |
January 2015 |
70.6% |
February 2015 |
82.1% |
March 2015 |
86.0% |
April 2015 |
25.7% |
May 2015 |
44.7% |
June 2015 |
74.5% |
July 2015 |
72.1% |
August 2015 |
75.5% |
September 2015 |
75.7% |
FY 2015 |
70.1% |
OPM also strives to decrease the processing time of claims older than 60 days. As of the end of FY 2015, claims adjudicated in more than 60 days had an average processing time of 88.6 days, down from the 119.3 days at the end of FY 2014.
A portion of OPM’s workload also involves retirement benefits provided by other agencies that need to be coordinated with OPM’s benefits, such as Federal Employees Retirement System disability benefits and Office of Worker’s Compensation Programs claims. For instance, the agency receives information from Social Security regularly for its Federal Employees Retirement System claims processing, and is discussing other process improvements. OPM also meets with both the U.S. Postal Service and National Personnel Records Center on a bi-weekly basis to discuss common issues attendant to retirement processing. The agency anticipates that using this internal and external process improvement approach will help OPM meet the 60 day goal.
OPM has embarked on five major IT initiatives that will ultimately lead to the realization of its IT strategic vision, including the Electronic Retirement Record, Retirement Data Repository, Data Bridge, Online Retirement Application, and Enterprise Case Management System. OPM posted two Requests for Quotations for the case management system. In August 2015, OPM awarded the first case management Blanket Purchase Agreement to acquire the enterprise level (agency) platform and translate business requirements into technical requirements. The second Request for Quotations focused on the services to build the configuration (including the online retirement application) upon the agency platform. OPM is also working to expand access to the Retirement Data Repository, via Data Viewer, to additional agencies. In FY 2015, OPM completed Phase 1 of the Data Viewer Expansion Project by adding access for 10 agencies, with more agencies anticipated in Phase 2. The Data Bridge is currently under construction. OPM has developed the web service to call Electronic Retirement Record data from the Retirement Data Repository and the Data Gateway to analyze the data and build business rules to transform and map the data to the retirement calculator. While OPM anticipates that the implementation of all of the components of its IT strategic vision will impact business operations, the agency cannot determine the impact of each individual system at this time.
In FY 2015, OPM actively encouraged individuals to take advantage of the resources available through Services Online, a web platform that provides retirement services on demand (https://www.servicesonline.opm.gov/). Services Online enhancements, such as improved password resets and lockout functions, have made access easier and increased functions. Enhancements include a new summary of payments and a view of life insurance coverage. More than 513,000 unique users accessed Services Online in FY 2015, conducting more than 5 million transactions.
OPM has relied on customer feedback, forward-focused initiatives, and process improvements to address customer needs. In FY 2015, OPM launched multiple customer service training initiatives for new and existing staff to improve customer service levels, focusing on improving quality. OPM has also added additional call center phone lines to allow for more callers and reduce busy signals. Due to reduced call center staff, there has been an increase in wait times and higher abandonment rates. OPM is exploring an increase in call center staff to address this issue.
A challenging component to implementing this strategy is the unexpected surge in normal retirement and phased retirement applications. When agencies make Voluntary Early Retirement Authority and Voluntary Separation Incentive Program offers, OPM may see a significant increase in retirement applications. OPM works closely with agencies to understand upcoming retirement offers; however, surges in retirement applications can occur outside of OPM’s control and predictions.
OPM tries to anticipate legislative challenges that may impact the strategy. For example, this may include a change in how retirement annuities are calculated (similar to the White House’s initiative on advanced sick leave).
OPM, in consultation with the Office of Management and Budget, has determined that performance toward this strategy is making noteworthy progress.