Dependent Eligibility Audit

Each year the University’s Benefits Committee – whose members include classified and unclassified staff and faculty – reviews the current benefits plan to determine if changes in benefits are needed, as well as to identify ways to keep the cost to the employee and the university as low as possible. The cost of health care continues to increase at a rate higher than inflation, and with our current benefits plan, the anticipated increase in costs for 2010 would be approximately $2.5 million. The Committee set a goal this year to reduce the anticipated health care cost increase by $500,000 to $1,000,000.

The primary action identified to meet this goal is a review of the eligibility* of dependents. Nationwide, such reviews have typically found that 5% of claimed dependents are actually ineligible. At that rate, the savings for the University are estimated to be $300,000 to $1,000,000. While Miami remains committed to maintaining high quality health benefits for all full time employees and their families, providing health care coverage for those not authorized to receive it increases the cost to both the university and its employees.

All employees and eligible* dependents will continue to be covered under the University’s benefits plans after eligibility has been certified.

An external consultant, HCS, has been hired to conduct this review. This month (May) you will be receiving correspondence from them; it is vital that you respond to their requests to certify your dependents as eligible*. Employees who fail to provide the requested information will find their dependents deemed ineligible and thus without health care coverage. We understand that this audit may prove burdensome and inconvenient, however, in a time of budget reductions, zero percent pay increases and when a number of Miami employees face layoffs, it would be unconscionable to not seek out every means to avoid unnecessary expenditures.

The Benefits Committee will continue to seek out other, innovative means to further reduce costs, and future recommendations are likely. As the audit begins please allow me to thank you in advance for your patience and understanding, and for your cooperation in verifying dependent eligibility*.

Correspondence from Ted Pickerill, Benefits Committee Chair; May 2009

Communication Plan

HCS will be communicating with all benefit-eligible employees who are covering dependents throughout the summer. All communication will be mailed to your home address in Miami University Benefit Services Envelopes. All responses and questions, though, are to be directed to HCS.

If you have questions regarding any of the correspondence , contact HCS directly at 866-617-4271.

Please follow the instructions of HCS in the time frame they allow to avoid any disruptions in your dependents' coverage. Eligibility documentation must be received by HCS no later than August 17, 2009.

*Who is an eligible dependent?

Spouse

The Employee’s spouse is recognized under the laws of the state where the Subscriber resides provided, however that the spouse shall be of the opposite gender, and that the spouse and the Subscriber share the same permanent residence.

Same Sex Domestic Partner

The Employee’s Same-Sex Domestic Partner is recognized based on completion of the Miami University Affidavit of Same-Sex Domestic Partnership.

Dependent Children

• Your unmarried, natural or legally adopted children, including children who have been
  placed with you for legal adoption.
• Your unmarried stepchildren who live with you or for whom your spouse is required to   
  provide medical coverage under a Qualified Medical Child Support Order (QMCSO).
• Any other children who are related to you by blood or marriage, who live with you in a
  regular parent-child relationship, and for whom you have obtained legal custody or
  guardianship.
• Children for whom you are required to provide medical coverage under a QMCSO.

Your dependent children (as described above) are covered:

• to the end of the year in which the child attains age 19
• to the end of the year in which the child attains age 24 if the child is documented as a full-time student enrolled in a state-accredited college, university, trade or secondary school on a full-time basis during calendar year 2009
• if any age and became disabled and incapable of self-support before their coverage would have otherwise ended.

Please note:

• No person can be covered both as an employee and as a dependent. 
• If a husband and wife are both eligible employees, only one may enroll their eligible dependents for coverage.
• No parents or grandparents, regardless of legal guardianship can be enrolled.