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Validation required for dependent health care eligibility

All UC faculty, staff and retirees who have dependents enrolled in UC-sponsored medical, dental and other insurance plans will be asked to validate their dependents’ eligibility in a project slated to begin in February 2012.

UC Human Resources is launching the project to de-enroll ineligible family members in order to insure compliance with UC’s Group Insurance Regulations and to fulfill UC’s fiduciary responsibility to its employees, retirees and the citizens of California.

“While the vast majority of our people enroll only eligible dependents, previous random reviews have uncovered a small percentage of people who either knowingly or unknowingly enroll ineligible people or fail to de-enroll dependents who are no longer eligible,” said Christopher Simon, director of systemwide HR compliance.

“A key fiduciary responsibility for UC as the plan administrator is to make sure the right people are covered.   Insuring ineligible dependents costs UC and its faculty, staff and retirees millions of dollars annually in premiums and other costs,” Simon said.  “It’s in the best interest of the University and our faculty, staff and retirees to be sure only eligible people are covered.  Every effort will be made to make the verification process as straightforward as possible.”

Employees and retirees who have enrolled dependents can prepare for the review in two ways:

  • Review currently enrolled family members to be sure they are eligible. If you aren’t sure whether your family members are eligible, read the Group Insurance Eligibility Factsheet for Employees or Retirees, available on the At Your Service website. You can de-enroll ineligible members by submitting a paper form to your local benefits office.
  • Gather documents you may need to provide including marriage and birth certificates, federal tax returns, court-ordered divorce decrees, custody agreements and other documents that verify your dependents’ eligibility for UC coverage.

If you believe all of your enrolled dependents are eligible for UC insurance, you need do nothing more now.  Watch for more information in early 2012.

If you have questions about eligible dependents, contact your local benefits office.

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