Benefits eligibility audit planned

Amnesty period to be offered

Plans are underway for a benefits audit designed to ensure that the individuals enrolled in U-M medical plans as dependents are qualified for coverage. The audit will begin in February 2010 and will be preceded by an amnesty period to run from now until Dec. 18.

The audit includes all faculty, staff and fellows with one or more dependents enrolled in a U-M medical plan, and requires a response to home mailings that begin in February. Retirees and their survivors and employees on long-term disability will be excluded from the audit.

“This process is important to help ensure good stewardship of our resources,” says Laurita Thomas, associate vice president for human resources. “We have a responsibility to be certain our plans operate as designed, and cost reduction also has been a result for many organizations. This type of financial stewardship is another way to help protect the long-term viability of our exceptional benefits program for faculty and staff and their dependents.”

About 20,000 U-M employees cover at least one adult or child dependent, and eligibility audits are increasingly common in universities with large numbers of people covered under the organizations’ benefit plans. Universities that already have conducted similar audits include Indiana University, University of Pennsylvania and Washington University in St. Louis.

U-M will coordinate the process with a firm that specializes in conducting confidential benefits eligibility audits to make the process as simple as possible because responding to audit letters is crucial, Thomas says.

Amnesty period, now through Dec. 18

Effective immediately, an amnesty period is being offered, during which faculty, staff and fellows can voluntarily disenroll dependents who do not meet eligibility requirements for U-M benefits without the possibility of disciplinary or legal action by the university, or other steps to recover costs. The amnesty period will run through Dec. 18, spanning this year’s Open Enrollment period to make the process of disenrollment of ineligible dependents simple and automated using Wolverine Access.

During the period before Open Enrollment begins and afterward through Dec. 18, ineligible dependents can be disenrolled without penalty by calling the HR/Payroll Service Center.

Audit process

Home mailings beginning in February to faculty, staff and fellows with enrolled dependents will include a questionnaire and a request to provide copies of specific documents to verify the eligibility of dependents. The types of documents requested will vary based on the category of adult or child dependent and will include options such as copies of federal tax returns with information such as social security numbers (SSN) and income figures removed, birth certificates and additional options currently being determined. No form of documentation will require SSN.

Enrolling ineligible individuals in university plans is against U-M policy, violates the certification of eligibility each employee agrees to during the enrollment process and may be insurance fraud. In the long run, the enrollment of ineligible dependents can end up costing everyone more in premiums and both the university and the insurance companies can take legal action.

To learn more about the eligibility requirements for the coverage of dependents, go to www.benefits.umich.edu/eligibility.

For more information, go to www.benefits.umich.edu or call the HR/Payroll Service Center at 734-615-2000.

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