[MyOEBB] OEBB's Dependent Eligibility Verification Review and Audit

Wed Dec 21 16:14:25 PST 2011

Dear Business Managers, Superintendents, and Benefits Administrators:

In OEBB's continuing efforts to provide quality, low-cost benefits for
Oregon's educational employees and their families, we will be conducting
a dependent eligibility verification review and audit from January 17 to
February 10, 2012.

This verification process will require a sample of OEBB members to
submit proof of the eligibility of all dependents currently enrolled in
their OEBB medical plan. The process will help OEBB ensure that only
dependents who qualify are covered under the benefits program.

Covering ineligible dependents on a benefits program increases costs for
everyone. Therefore, dependent eligibility verification processes have
become common practice among employers, and we believe it is an
important practice for OEBB as part of our commitment to fiscal
responsibility. 

OEBB has partnered with Towers Watson, a global professional services
firm that specializes in dependent eligibility verification processes,
to perform this review and audit. Working with a third party like Towers
Watson reinforces the confidentiality of the verification process.

For those of you who joined the Benefit Information Exchange (BIE)
meeting on Thursday, December 15, to hear more about the review and
audit process, the following explanation of how OEBB will proceed with
this process has changed slightly.  During the presentation by Towers
Watson, we indicated that just over 1,200 employees, early retirees and
COBRA participants who cover dependents did not go into MyOEBB during
the open enrollment period to verify their dependents' eligibility
(i.e., were considered "non-responders").  Following a review of the
methodology used  by OEBB's programmers to identify individuals
identified as "non-responders," it was determined that there were
actually 9,271 employees, early retirees and COBRA participants who did
not enter MyOEBB during the open enrollment period and verify the
eligibility of their covered dependents.  Therefore, we were required to
change the way we identified who would be included in the review and
audit beginning next month as outlined below. 

The Verification Process 

For this review and audit, Towers Watson will select a random sample of
4,000 OEBB members who were covering at least one dependent on their
OEBB medical plan on December 1, 2011. During the 2011 Open Enrollment
period, members were encouraged to log into the MyOEBB system and verify
the eligibility of all dependents enrolled in their plans - 9,271
members with a dependent on their medical plan did not complete this
online verification process. This group will be randomly sampled at a
higher rate. Of the 4,000 selected for the audit process, 2,300 will be
selected from this group. The remaining 1,700 included in the review and
audit will be randomly selected from those employees who participated in
the dependent verification process during open enrollment. All 4,000
members selected for the audit will be required to provide documentation
(e.g., copies of birth certificate, marriage certificate, etc.) to prove
each dependent's eligibility for coverage on an OEBB benefit plan.

Members may respond to the request through a convenient and secure
online process that allows them to submit required dependent
documentation electronically. Members may also choose to complete this
process through mail or via fax by completing a form which will be
included in a Verification Packet mailed to homes. Members who do not
use the online system will need to complete and return this form with
the required documentation. Members must complete the verification
process by February 10, 2012.

If members do not provide proper documentation, any unverified
dependents will be terminated from all OEBB benefit plans on or before
March 31, 2012 and offered COBRA continuation of benefits coverage.
Notification letters will be mailed to these members prior to coverage
terminating and educational entities will receive notification from OEBB
so any necessary payroll adjustments can be made.

A detailed timeline is attached as well as advance copies of all the
communications to be delivered throughout the process.

Questions

If you have any questions regarding the dependent eligibility
verification process, please contact OEBB Member Services at
888-4MY-OEBB (888-469-6322). Thank you for your support with this
important initiative. 

Sincerely,

Denise L. Hall

Denise L. Hall, Deputy Administrator

Oregon Educators Benefit Board

http://egov.oregon.gov/OHA/OEBB <http://egov.oregon.gov/DAS/OEBB> 

(503) 378-5133

(503) 378-5832 FAX

OEBB encourages all members to stay healthy and be happy!!!!     Pass it
on.....  http://www.oregon.gov/OHA/OEBB/WellLinks.shtml
<http://www.oregon.gov/OHA/OEBB/WellLinks.shtml>     

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************************************ 

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