Does your company VERIFY your dependent's eligibility for coverage?

[TangoWhiskey]

OK, this is a first for me, at any company I've ever worked for (I've been at this current firm for 5 years, and it's their first time doing this, too, from what I'm told). Every employee received a two page double-sided letter at home yesterday requiring us to submit proof, to a third-party company performing the audit, by August 2nd, that our dependents are eligible for medical insurance coverage.

For spouses (yes, we have to validate not just kids, but spouses / domestic partners): A copy of your marriage certificate, AND a copy of the front page of your 2009 filed federal tax return, or ONE form of documentation dated within the last 6 months establishing current relationship status, such as a joint household bill, bank/credit joint account / mortgage / lease, or insurance policies. Documents must list you and your spouse's name, the date, and mailing address.

For domestic partners: A completed affidavit of domestic partnership form AND TWO forms of documentation dated within the last 6 months establishing current relationship status, such as a joint household bill, bank/credit joint account / mortgage / lease, or insurance policies. Documents must list you and your partner's name, the date, and mailing address.

For children (up to age 19) or disabled dependents: A copy of the child's birth certificate naming you as the child's parent, or appropriate court order/adoption decree naming you as the child's legal guardian. For stepchildren, a copy of your marriage certificate to the child's biological parent will also be required in addition to the legal guardianship document. For other legal guardianship or disabled dependent relationships, a copy of the front page of the employee's 2009 filed federal tax return confirming the status of the child as a dependent will also be required.

For students (age 19 to 25): Provide copies of the documentation from the CHILDREN's required documentation list above, AND a copy of the student's Fall 2010 official college or university course schedule, tuition bill or enrollment verification statement that confirms the dependent's status as a full-time student (12 hours or more as an undergraduate, 9 hours or more as a graduate student). The student's name, enrollment dates, credit hours and/or status, and the name of the educational institution must be included.

This is not a small company--40,000 employees. They say the reason for doing this:

We're taking steps to help ensure that only eligible dependents are covered. We're sensitive to the rising costs of health care for our employees and feel that this verification is necessary:

• In order to control costs; health dollars should only pay for expenses incurred by eligible dependents.
• As laws become more stringent, dependent verification is an important tool to maintain enrollment accuracy and prevent fraud.

The letter goes on to say that employees will not be reimbursed costs, fees, or expenses incurred to gather the required documentation by the August 2nd deadline; that the company may seek to recover all claims paid during any period that an ineligible dependent was covered; and that disciplinary action may be taken against employees that had an ineligible dependent covered.

I understand the need to control costs and fraud. I can't help but think this will cost them more, in fees to the third-party company and employee goodwill, than they'll recoup in removing any ineligible dependents.

Welcome to the future. Would you stay at a company that asked for this kind of documentation?

 

[DawnW]

I worked for a company that did this and the return on their investment in the auditor definitely paid off. I was surprised at the number of ineligible dependents they found.

 

[woodstock]

I am more surprised at the thought that companies don't ask for this already. Being single, I have no first hand experience in it, but I assumed all did and should?

 

[Trapper John]

I've had to provide proof of university enrollment for kids in college directly to the insurance carrier, but I've never seen anything like this. A copy of your 1040? That's a little over the top - marriage license, fine. If they want to dispute that, let them do the legwork to prove you're divorced.

 

[TangoWhiskey]

I would think a copy of the front page of my tax return, showing ages and names and relationships of dependents, plus a copy of any college student's enrollment, would be sufficient. I chafe at sending marriage certificates, birth certificates and other legal docs to a third party.

 

[bstratt]

Yep, for the first time. Just faxed in mine this morning.

 

[TangoWhiskey]

I've had to provide proof of university enrollment for kids in college directly to the insurance carrier, but I've never seen anything like this. A copy of your 1040? That's a little over the top - marriage license, fine. If they want to dispute that, let them do the legwork to prove you're divorced.

In all fairness, the filed tax return information that they want is JUST the front page, with SSN's and financial figures blacked out.

 

[tonycondon]

i bet it doesnt cost much to gather the data compared to a few 100K+ hospital visits that are basically insurance fraud.

 

[TangoWhiskey]

I am more surprised at the thought that companies don't ask for this already. Being single, I have no first hand experience in it, but I assumed all did and should?

I agree! Big loophole. I guess they're working on closing it.

I'm not worried about it, as I'm not claiming anybody fraudulently... maybe that's why it bothers me?

 

[CJones]

I agree! Big loophole. I guess they're working on closing it.

I'm not worried about it, as I'm not claiming anybody fraudulently... maybe that's why it bothers me?

I'm betting there are a LOT of people that are shaking in their boots right now saying "WTF do I do now!?"

... actually, they're probably thinking "Oh well, I'll just play dumb and get out of it."

 

[weilke]

Now that the companies will be forced to cover your brood until 26 years by federal fiat, they are starting to look at trimming the rolls pre-emptively.

There may also be tax implications for the company if they are found to cover noneligible dependents.

Whenever you encounter something bizarre, the first thought should be: I bet this is the result of a federal regulation

Right now I am faced with a situation where the bennies for my kids would be better if I got divorced. Go figure.

 

[jtheune]

I would think that any company that is not willing to trust that the information that it's employees gave it in terms of names, date of birth and ssn for their dependents is valid is not going to trust that those same employees are not stealing from them. If you don't trust your employees to give you valid information then you might want to get a new set of employees. All the companies I've worked for have all had statements in the hiring and benefits paperwork that said if you lie you die ( or words to that effect ) I also have a problem with a company that mandates that I show them my tax return. It's none of their business how much money I or my spouse reports to the government.

 

[wabower]

Don't you have a joint checking account somewhere? Just obliterate the account number and sig block and send them a copy. Re kids, just send them a notarized affidavit.

PS: And one more reason I couldn't ever bring myself to work for any company I didn't own or run.

I would think a copy of the front page of my tax return, showing ages and names and relationships of dependents, plus a copy of any college student's enrollment, would be sufficient. I chafe at sending marriage certificates, birth certificates and other legal docs to a third party.

 

[mantakos]

I find it curious whenever somebody asks for a copy of your tax return as "proof" of something. They're basically saying "to provide proof of your claim, provide us with a piece of paper on which you've written some information that says your claim is true".
-harry

 

[JeffDG]

Had to do an audit like this last fall myself.

 

[dmccormack]

I find it curious whenever somebody asks for a copy of your tax return as "proof" of something. They're basically saying "to provide proof of your claim, provide us with a piece of paper on which you've written some information that says your claim is true".
-harry

Which is why you need paper to prove your "identity."

"I'm standing here-- this is me..."

"Nope -- I gotta have 'proof.'"

 

[TangoWhiskey]

Don't you have a joint checking account somewhere? Just obliterate the account number and sig block and send them a copy. Re kids, just send them a notarized affidavit.

PS: And one more reason I couldn't ever bring myself to work for any company I didn't own or run.

Notarized affidavit is not sufficient. Per the letter, if you don't send the required docs by the date stated, coverage will be dropped, even if the dependents ARE otherwise eligible for coverage.

 

[TangoWhiskey]

I find it curious whenever somebody asks for a copy of your tax return as "proof" of something. They're basically saying "to provide proof of your claim, provide us with a piece of paper on which you've written some information that says your claim is true".
-harry

Yeah, me too! Do mortgage companies and banks have a way to compare what you send them with what you actually sent to the IRS? I could see somebody creating two tax returns each year--their actual return, and the one they keep on file to send to banks with loan apps, with better numbers.

 

[Capt. Geoffrey Thorpe]

BTDT.

 

[astanley]

a) Remember who you work for. There is a huge division there that does this type of outsourcing, and I bet it's a "dogfood" approach.
b) Also remember the significant size of the MA based workforce -- where domestic partnerships are legal and insurable. It's quite possible someone down in your office has "slipped under the radar" and potentially received benefits for something they aren't entitled to (because they live in Texas, and not Massachusetts).
c) I've had to prove my relationships in the past; Jessie actually keeps a file at home that, in one fell swoop, can prove our identity, mobility, and the nature of our relationship. It skeeves me out from time to time, but it helps in a pinch.

Cheers,

-Andrew

 

[mikea]

I'm betting there are a LOT of people that are shaking in their boots right now saying "WTF do I do now!?"

... actually, they're probably thinking "Oh well, I'll just play dumb and get out of it."

They gotta hope that the company doesn't can them for making false claims and go after them for the previous year's "free" premiums.

I'm sure this fraud is common enough that they'll dig up that like 20% or more dependents are fraudulent. People see no harm like when they put the kids in better schools where they don't live so those taxpayers can pay for them.

The premiums are huge. The companies don't pay a lot less than an individual does. Get a quote and you'll find out that it's $700-$2000 a month depending on your age.

 

[mikea]

Yeah, me too! Do mortgage companies and banks have a way to compare what you send them with what you actually sent to the IRS? I could see somebody creating two tax returns each year--their actual return, and the one they keep on file to send to banks with loan apps, with better numbers.

The lenders make you sign an IRS "Copy of tax return" form authorizing then to pull tax return data from the IRS.

 

[weilke]

Yeah, me too! Do mortgage companies and banks have a way to compare what you send them with what you actually sent to the IRS? I could see somebody creating two tax returns each year--their actual return, and the one they keep on file to send to banks with loan apps, with better numbers.

That is how we ended up in the mortgage mess.

They do. Somewhere, hiding deep in the paperwork during a mortgage application you give them permission to obtain your 'tax abstract'. That is a text printout that contains everything you filled in in the form 1040 and some of its attachments as it is stored in the big goverment computer. When mortgage lending was a risk-free activity, the lenders often skipped that step and took whatever they where given at face value.

 

[wabower]

"In that case, do you have a mirror handy? If so, I'll look in it to be sure it's me."

Which is why you need paper to prove your "identity."

"I'm standing here-- this is me..."

"Nope -- I gotta have 'proof.'"

 

[Ghery]

Marriage license? No problem. It's a public record and I found a copy from the state on the internet. That was easier than finding the original at home (although I bet my wife could lay her hands on it in a matter of seconds). And I don't cover her on my company's health plan. She has better coverage through the school district where she teaches. I use her vision care coverage rather than my employer's coverage.

 

[Henning]

Welcome to the future. Would you stay at a company that asked for this kind of documentation?

Yes, yes I would. They are showing that they will take the required steps to assure the companies future viability and performance. As has been said "The Devil is in the details", and it's details like this that make the difference as to whether a company survives in the long term or not. You may be very surprised at what this little exercise shakes out as well. Insurance fraud is a game every demographic likes to play.

 

[JeffDG]

Yes, yes I would. They are showing that they will take the required steps to assure the companies future viability and performance. As has been said "The Devil is in the details", and it's details like this that make the difference as to whether a company survives in the long term or not. You may be very surprised at what this little exercise shakes out as well. Insurance fraud is a game every demographic likes to play.

Ding! Ding! Ding!

 

[EdFred]

De-pen-what?

 

[Henning]

De-pen-what?

Them things running around your neighbors yard that you shoot with a BB gun....

 

[TangoWhiskey]

Yes, yes I would. They are showing that they will take the required steps to assure the companies future viability and performance. As has been said "The Devil is in the details", and it's details like this that make the difference as to whether a company survives in the long term or not. You may be very surprised at what this little exercise shakes out as well. Insurance fraud is a game every demographic likes to play.

I don't think that anybody except those in the department doing the audit, or the upper management, will ever know the results... even in the abstract, much less the particulars.

 

[jason]

Yes, yes I would. They are showing that they will take the required steps to assure the companies future viability and performance. As has been said "The Devil is in the details", and it's details like this that make the difference as to whether a company survives in the long term or not. You may be very surprised at what this little exercise shakes out as well. Insurance fraud is a game every demographic likes to play.

+1

Just remember that anybody that they uncover is raising the cost of your premiums and costing the company money. Remember those recent layoffs?

 

[Everskyward]

I am more surprised at the thought that companies don't ask for this already. Being single, I have no first hand experience in it, but I assumed all did and should?

I never thought about it either, but I can understand why they would require it.

 

[SCCutler]

Responsible corporate governance, is what it is.

With increasing intrusion of the federal government into matters which are none of their affair, and statutory and regulatory implications, the necessity to trim any currently-ineligible persons from the insurance rolls has never been greater.

 

[TangoWhiskey]

Well, then, I'll gladly participate! ;-)

 

[geneseib]

Welcome to the future. Would you stay at a company that asked for this kind of documentation?

Why would you stay at a company that wouldn't. Fraud raises costs for us all.

 

[AuntPeggy]

I don't think that anybody except those in the department doing the audit, or the upper management, will ever know the results... even in the abstract, much less the particulars.

You are kidding. Right?

 

[wpierce]

I work for a company with over 60,000 employees. This year I got picked in our random drawing of whatever percent of the employees get that letter. As expected there was quite a bit of complaining from those asked to participate in this. We were informed that if we did not send in the required information that our insurance benefits would be terminated.

I also know that the first year we did this, there was a quite a substantial amount of money that was being paid out that shouldn't have been. I don't believe the employee will ever see a benefit of our Insurance costs going down, rather I believer the company will see the savings in cost that were being paid out fraudulently.

 

[TangoWhiskey]

You are kidding. Right?

Nope. I'll be pleasantly surprised if we get a memo later telling us the outcome of the audit.

 

[TangoWhiskey]

Why would you stay at a company that wouldn't. Fraud raises costs for us all.

Agreed. I guess being an honest person, it feels a little "police state like". But, I've learned from the comments on this thread that the practice (of fraud, that is) seems to be widespread enough to warrant such an audit. If it saves the company that much money, and keeps the pool clean, I'll gladly participate.

 

[Trapper John]

Responsible corporate governance, is what it is.

With increasing intrusion of the federal government into matters which are none of their affair, and statutory and regulatory implications, the necessity to trim any currently-ineligible persons from the insurance rolls has never been greater.

So, in other words, it takes the threat of regulation to stimulate responsible corporate governance...