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FAQ - Dependent Eligibility Verification Audit

Did I have to attach the Required Affidavit Signature Form with my documentation?

Yes, returning the Required Affidavit Signature Form along with your documentation for all dependents you were verifying was required.

Did I have to send original documentation?

No. Copies were all that was required.

Did I have to submit documentation for my over-age dependent who is eligible for Chapter 375 and/or COBRA?

Yes, required documentation to verify that he or she was eligible for Chapter 375 and/or COBRA was required.

Has the deadline to submit documentation for the Dependent Eligibility Verification Audit to Aon Consulting been extended?

No, the deadline has not been extended for members of the SHBP included in   Phase I of the Dependent Eligibility Verification Audit.  Since Rutgers University employees were included in Phase 1 of the DEVA audit, the current deadline of February 1, 2010 and the appeal procedure remain in effect.  The state is beginning Phase 2 of the Dependent Eligibility Verification Audit for Local Employers (i.e. Townships).  The DEVA audit dates and deadlines for the Local Employers in Phase 2 do not apply to Rutgers employees.

How long will the coverage be extended for my child?

Coverage will be extended to eligible children through December 31 of the year the child turns age 26.

I am a new employee. Do I have to include documentation for my dependents?

As of January 1, 2009, all new employees must provide the required documentation to prove eligibility. The Dependent Eligibility Verification Audit Chart describes what documentation is needed.

I am a retiree covering a dependent. Did I have to submit proper documentation?

Yes. Anyone covering an eligible dependent was required to submit the proper documentation.

I am making a change to my coverage. Do I have to attach anything?

If you are adding dependents for coverage, proof of eligibility will be required. If the proper certifications are already on file, you may not have to resubmit documentation.

If I'm notified that my dependent(s) will be terminated, what are my options?

Members may appeal a termination if they comply with the audit and provide proof of a dependent(s)' eligibility by submitting the required documentation to the Health Benefits Bureau of the Division of Pensions and Benefits.  Appeals must be in writing and directed to:

Appeals Coordinator, Division of Pensions and Benefits
PO Box 299
Trenton, NJ 08625-0299
.

Appeals must include a cover letter with the full names and Social Security numbers of the member and all dependents along with the member's mailing address and daytime telephone number.  Be sure to also include a detailed explanation of the reason for the appeal and copies of all documents required for proof of the dependent(s)' eligibility for coverage (Dependent Eligibility Verification Audit Chart)

If a member's appeal was submitted to the Appeals Coordinator by March 8, 2010 and the Appeals Coordinator determined that a member complied with the audit and provided proof of a dependent(s)' eligibility, dependent(s) coverage will be reinstated effective February 1, 2010.  If a member's appeal is submitted later than March 8, 2010 and the Appeals Coordinator determines that a member complied with the audit and provided proof of dependent(s)' eligibility, dependent(s) coverage will be reinstated in a timely manner (effective either the 1st of the current month of determination or the 1st of the following month).

If my spouse and I filed our taxes separately, what tax documentation was required to provide to the SHBP?

You and your partner were required to provide the top half of each of your federal tax returns.

My child is currently covered under Chapter 375; may I reenroll the child under my plan?

Yes, children under age 26 may be reenrolled in the SHBP plan.

What are the eligibility criteria for children to be covered until age 26?

A “child” is defined as an enrollee’s child until age 26, regardless of the child’s marital, student, or financial dependency status even if the young adult no longer lives with his or her parents and is eligible for other employer-based coverage.

What are the options for continuing coverage for ineligible dependents?

Termination of an ineligible dependent who was not eligible for coverage is not considered a COBRA Qualifying Event.  In certain circumstances, where an eligible dependent became ineligible within the last 60 days, COBRA may be offered.  Please contact the Division of Pensions and Benefits at 609-292-7524 for clarification regarding possible continuation of coverage for such dependents.

What documentation is required to enroll the child?

For all enrollments a photocopy of the child's birth certificate that includes the covered parent’s name (or other supporting documentation for foster or stepchildren) must be submitted along with State Health Benefit Program Medical and Dental applications to:

University Human Resources-Benefits Enrollment
ASB II, Cook Campus.

What documentation was required?

The Dependent Eligibility Verification Audit Chart describes what documentation was required for each dependent.

What happened to the copies of the requested documentation once it was received by the Division of Pensions and Benefits? Is my information safe?

The copies were scanned into the State Health Benefits (SHBP) system and the electronic file or data was only available to authorized SHBP representatives. The copies were then shredded. The Division of Pensions and Benefits maintains a high level of confidentiality.

What happens if I failed to respond to the Dependent Eligibility Verification Audit?

If you did not respond to the audit in providing the required documentation to verify eligibility, your dependent(s) coverage in the State Health Benefits Program (SHBP) will be terminated effective February 1, 2010.  Beginning January 7, 2010, the SHBP mailed letters to affected members indicating that dependents will be terminated for noncompliance with the audit.

What is the Patient Protection and Affordable Care Act (PPACA)?

In March 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into Federal law. One of the provisions of the federal Patient Protection and Affordable Care Act (PPACA) extends insurance coverage of children until age 26.

When can I enroll my eligible child?

Eligible children may be enrolled during the annual Open Enrollment period. Elections made during the Open Enrollment Period will become effective the following January 1.

Where can I obtain additional information about the Dependent Eligibility Verification Audit?

Contact the Division of Pensions and Benefits at 609-292-7524

Where may I obtain additional information?

You may contact a Benefits Specialist at 848-932-3990 or via email at benefits@hr.rutgers.edu.

Which dependent types were verified?

All eligible dependent types (spouses, children, civil union partners, domestic partners, disabled dependents and continued coverage for overage children) were verified to maintain coverage for these dependents.

Who is Aon Consulting?

SHBP retained Aon Consulting, a very reputable consulting company, to perform the Dependent Eligibility Verification Audit.

Why was the audit conducted?

The NJ Division of Pensions and Benefits secured Aon Consulting to review State Health Benefits Program (SHBP) records to ensure that only eligible dependents were covered under the SHBP.

Will I pay more for the extended coverage?

There is no additional cost.