The State Health Plan is verifying the eligibility of all dependents covered on the State Health Plan, according to Human Resource Services. This initiative consists of a six-week Verification Period during which all members must provide proof of eligibility for each of their dependents enrolled for coverage under the State Health Plan during the 2010-11 Plan Year.
Why is the State Health Plan Conducting a Dependent Verification?
The State Health Plan is committed to providing comprehensive health benefits to members and their families. Confirming the eligibility of dependents is an active measure that we can take to control costs for both members and taxpayers.
The dependent verification process will help the State Health Plan to:
- ensure dependent records are up-to-date;
- confirm that each dependent enrolled in the State Health Plan is eligible for coverage under the rules of the State Health Plan; and
- discontinue coverage for ineligible dependents.
This process is quickly becoming a “best practice” among state health plans. In fact, Georgia, Virginia, Ohio, Tennessee and Hawaii have already conducted similar dependent verification initiatives for their state plans.
Who Will Administer the Verification Process?
Secova, a human resources and health benefits services company, will administer the Dependent Eligibility Verification process on the State’s behalf. Secova has extensive experience facilitating this process for public sector entities. Secova will be responsible for sending member communications, answering questions via a toll-free call center, and providing secure channels to receive documentation to ensure that private employee and dependent information is kept confidential.
How the Dependent Verification Process Will Work
All State Health Plan subscribers who have dependents covered under the State Health Plan will receive a letter from Secova that details the verification process and lists the dependents covered by the State Health Plan during the 2010-2011 Plan Year. The letter will also outline the required documentation (birth certificates, marriage certificates, tax returns, etc.) that must be provided to confirm dependent eligibility.
Members will be asked to complete and submit a signed Verification Form to Secova, along with the appropriate documentation, by October 15, 2010. Members may submit the documentation in one of three ways:
- By mail (only copies should be sent) to: Secova Eastern Service Center PO Box 1901 Wall, NJ 07719-9966, or
- By fax, to 1-866-239-5947, a secure electronic fax service operated by Secova, or
- Via web upload, by scanning and uploading the documentation to Secova’s Dependent Eligibility Verification secure website: https://verify.secova.com/NorthCarolina
Please note that in order to log into the web site you will need your Member ID#. It is included on the Cover Sheet for Dependent Verification document that is in your Verification Packet.
All information provided will be kept confidential. Paper documentation provided by subscribers will be shredded when the verification process is complete. For this reason, it is important that subscribers send only copies – not original documents – as verification.
Members who submit a properly completed form and provide acceptable documentation will receive a personalized confirmation letter from Secova; no further action will be required. Members who do not submit a properly completed form and/or do not provide documentation by August 30, 2010, will receive a reminder letter about the approaching dependent verification deadline.
Finally, a suspension of coverage letter will be sent to members who do not respond to the dependent verification request by Oct. 15, 2010. This letter will inform members that their dependents will be dropped from coverage, retroactive to July 1, 2010.
Members whose dependents are removed from coverage may file an appeal. The deadline for filing an appeal is Dec. 15, 2010. Note: Members covering ineligible dependents will be asked to pay for any claims incurred by their ineligible dependents on or after July 1, 2010.
Who is an Eligible Dependent?
- An “eligible dependent” of a covered employee is:
- A legal spouse;
- An unmarried child under age 26 including natural, legally adopted, foster children, children for whom the employee is a court-ordered guardian and stepchildren of the employee, as long as the employee is legally responsible for such child’s maintenance and support;
- An unmarried child who is physically or mentally incapacitated, to the extent that he or she is incapable of earning a living, and such handicap developed or began to develop before the dependent’s 26th birthday.
For More Information
For more information about the dependent verification effort, members may contact Secova at 1-888-541-8123 (toll-free).