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Tennessee Secretary of State Tre Hargett
Records Management Division
RDA
RDA Management System
RDA Details
RDA
RDA: 11367
Database ID: 2625
Record Series Title: Benefit Administration Enrollment and Authorization Forms
Record Series Abstract: Benefit Administration Enrollment and Authorization Forms generated by the Finance and Administration Benefit Division. The record series includes but not limited to Active and Retiree Enrollment Change and Cancel Request forms, Flexible Benefit and Leave of Absence forms, ACH & HIPAA Authorization forms and supporting documentation.
Record Series Active: Yes
Cut Off at End of: Other
If Other, Explain: When employee terminates from the plan
Total Retention: 65 Years 0 Months
Retention End Action: Destroy
Disposition Notes: The records are to be scanned and stored on electronic server, the hard copies are to be destroyed upon verification that the records were properly scanned and uploaded to the server; maintain in agency 65 years after employee/member terminates from plan, then destroy by approved methods.
View Signed Form: Form Not Received
Worksheet
Worksheet ID: 2819
Record Location: 312 Rosa Parks Ave. Nashville, TN
File Arrangement: Multiple indexing alpha and Edison ID
Media Format Generated: Both
Media Format Stored: Electronic: Text
Date Range: 2008-Current
Annual Accumulation: 26,221mb 500 CF
Current Volume: 25gb 500 CF
Record Value: Administrative, Fiscal
Audit Requirements: State
Reference Frequency:
Current Year per Month: 0
Past Year: 1
2 - 5 Years: 2
Over 5 Years: 5
Data Update Frequency: Monthly
Information Shared Outside of State: No
If Shared, List Agencies:
Essential Record: No
Essential Record Stored:
Essential Record Media Type:
Confidential: Yes
Confidential Legal Citation: 45 CFR 164.306, 45 CFR 164.304, 45 CFR § 160.103
Media Recommendation: Current Format
Media Recommendation Other:
Agency Retention:
Agency Retention - Years Active: 1
Agency Retention - Years Inactive: 64
Records Center Retention Period: NA
Final Disposition after Retention Expires: Destroy
Legal Citation: 45 CFR 164.306, 45 CFR 164.304, 45 CFR § 160.103
Record Sample: No Sample
Legal Documentation: No Legal Documentation
Electronic Records Plan Inventory
System Name: FileNet
IT-ABC Number:
Hardware Description: Images stored on two storage devices - Data Center North and Data Center South
Software Description: IBF FileNet Software for Images- Microsoft for Index values
System Location: Data Center North Nashville Tennessee Data Center South Smyrna Tennessee
Backup Procedures: State standard at both Centers encrypted by Enterprise Software
Disaster Recovery: State of Tennessee standard for both Centers using offsite storage facilities
Data Migration Description: Full Migration Plan on File with STS
Metadata Description: Metadata is preserved on a per application basis not across Enterprise
Contact Information
Contact Name: Linda Deason
Job Title: Administrative Services Assistant 3
Address 1: 312 Rosa Parks Ave.
Address 2: 20th Floor
City: Nashville
Zip: 37243
Phone: 615-741-5100
Email: linda.deason@tn.gov
Agency: Dept. of Finance and Administration
Agency Head: Stuart McWhorter
Director: Veronica Coleman
Allotment Code: 31704
Status
Action Requested: New RDA
Comments
  Date Comments
Records Management Division (RMD): 10-17-2019 No recommended changes.
Tennessee State Libary and Archives: 10-17-2019 No recommended changes.
Comptroller Audit Review: 2019-10-17 We have reviewed RDA ID 2625 from an audit standpoint. We concur with the recommended retention and disposition specifications.
Agency: 10-18-2019 Agency concurs.
RMD Director Recomendations: 10-23-2019 RDA 11367 is a request to create an RDA. The retention period will be sixty five years and destroy. The format will be paper/electronic. Recommend approval of request to create RDA 11367.
Signed Form Received: 2019-10-21
PRC Meeting Date: 11-12-2019
PRC Comments: PRC approves RDA 11367.
PRC Action: Approved
RDA History
ID RDA PRC Reviewed PRC Action
2625 11367 2019-11-12 Approved