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The Human Resources benefits division will conduct an audit later
this year to verify the eligibility of each dependent covered by
the city ‘s health plans. The city’s dental, basic life
insurance, voluntary life insurance and AFLAC supplemental plans
also will be audited.
If you have dependents enrolled in a city health plan, you should
have received a letter from the benefits division asking you to
verify either the eligibility of your covered dependents or to stop
coverage on your ineligible dependents.
Who may be covered:
• Your legal spouse from a formal or informal marriage,
or your former spouse entitled to support under a court order. Only
one spouse or ex-spouse may be covered at a time.
• Your natural or adopted children under 25.
• Your stepchildren and grandchildren under 25 who are primarily
dependent on you for federal income tax purposes and are living
with you.
• Your child for whom your spouse or you are a court-appointed
guardian.
• Your child of any age who is incapable of self-sustaining
employment because of mental retardation or physical handicap.
If your benefits file does not contain documents that support
the eligibility of the people listed on your health plan, you may
be required to submit those documents. They include a birth certificate,
birth fact for a newborn, marriage license, declaration and certification
of an informal marriage for a common-law marriage, legal documents
for children for whom you are guardian or children placed in your
home pending adoption, and a divorce decree or death certificate.
During the audit, benefits employees will be looking for unusual
relationships, such as children and parents too close in age, listed
children who are older than the parents, more than one spouse, or
a large gap in the children’s ages.
If you are covering someone who is ineligible for city health
benefits, you should immediately complete the required forms to
drop ineligible dependents. Consult your human resources liaison
for the forms. You may drop ineligible dependents by April 30 without
penalty. After May 1, a penalty, including a possible fine, will
be assessed for ineligible dependents.
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| If you are covering
someone who is ineligible for city health benefits, you should
immediately complete the required forms to drop that person.
After May 1, a penalty, including a possible fine, will be assessed
for ineligible dependents. |
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