Dependent Eligibility Verification (Project Complete)

This summer, the University of Iowa asked employees with dependents listed on their UIChoice plan as of June 1, 2018, to verify their eligibility for plan coverage. The university hired Health Management Systems (HMS), a third-party vendor that provides services to organizations, to conduct this verification.

University Human Resources would like to thank the campus community for their participation in this project. The audit was a significant effort by the university community and its success is largely due to the hard work of participating faculty and staff as well as the HR community who provided ongoing assistance. Thank you to everyone involved.

Key Dates

  • June 26, 2018:  HMS letter mailing to UIChoice plan participants who have dependent coverage in place as of June 1, 2018; Employee Verification Phase begins
  • September 10, 2018:  Verification Phase ends; materials verifying employee dependents must be sent to HMS by this day
  • September 28, 2018: Verification Phase extended for those employees that did not complete their submission by September 10, 2018 
  • January 1, 2019:  Any ineligible or unverified dependents will be removed from the UIChoice plan

Verification Results Summary

The university emailed all affected employees to inform them of the Dependent Eligibility Verification Audit, and HMS sent letters to those employees at their home addresses. Individuals who did not respond to notifications received a total of nine messages over the audit’s three-month span.

Employees were asked to provide documents to HMS that verified their dependent’s eligibility for UIChoice plan coverage. According to plan policy, spouses, partners, common-law-spouses, and children are eligible to be listed as dependents. Marriage and birth certificates are a common way to verify eligibility.

Security was a major focus of this process and HMS adheres to all state and federal regulations regarding the security of private information. HMS will securely destroy all private or sensitive documents given to them by UI employees for purposes of the audit within six months of the audit close. 

At the beginning of the audit, there were 10,142 employees with dependents listed on their UIChoice plan and 24,190 dependents covered.

HMS reports that the audit received a very strong participation rate from UI employees with 98.3 percent (9,971 employees) responding to communications. At the audit’s close, 93.5 percent of dependents (22,629 individuals) were verified as eligible for continued plan coverage.

About 3.3 percent (807 dependents) were either unverified at the audit’s close, had volunteered for removal, or were determined by HMS to be ineligible for plan coverage given the guidelines provided by the university. Unverified dependents resulted from either a failure to respond to notifications or insufficient documentation provided to HMS. These 807 dependents will be removed from plan coverage as of Jan. 1, 2019.

HMS reported that of those unverified, voluntarily removed, or ineligible dependents, 554 were listed as children and 253 as a spouse or domestic partner. Children commonly become ineligible for coverage as a dependent when they exceed 26 years of age. Spouses commonly become ineligible or leave coverage due to divorce, death, or a change in employment and health insurance options.

In addition to the dependents above, 754 dependents (3.1 percent) were removed from coverage because the corresponding employee ended employment during the audit’s time-frame and were therefore no longer eligible for university benefit offerings. 

The university’s total payments to HMS for audit-related services amount to about $137,000. Based on industry standards, HMS estimates that the dependents removed from the plan represent about $2.8 million in annual cost avoidance for the university.

For more information on or questions regarding the audit results, contact Rebecca Olson at rebecca-s-olson@uiowa.edu