HCPSS Health Insurance Dependent Eligibility Verification Audit

Published on
Fri, 03/10/2023 - 1:03 PM

In April 2023, the Howard County Public School System will be asking all employees to verify their dependents who are receiving health insurance. This process will be mandatory for all employees who receive health insurance through HCPSS and will ensure the school system is only paying for health benefits for eligible dependents. This process is important because paying for ineligible dependents drives up the insurance premiums for all employees.

Employees will receive more information in April when the process begins. The information below will help you better understand why this is occurring and how to prepare.

Why Is HCPSS Doing This?

National statistics show that each ineligible dependent costs the plan’s members an average of $4,500 per year. That can mean higher premiums and fewer benefits for all employees and their families. Eliminating these wasted dollars will help control our healthcare costs  ̶  and save you money as well.     

How Will It Work?

In April, you will be instructed to visit an online form and provide information about your current spouse and children you claim as dependents. This process takes less than 10 minutes. Instructions will be provided for those with limited or no internet access to be able to submit your information in an alternative way.

Then, you will be asked to submit documents that verify the information you provided online. You will be guided step-by-step throughout the entire process. It’s convenient and easy. 

How Can I Prepare Ahead of Time?

Typically, the documents you should have available include current income tax forms or a marriage certificate, current joint financial statements for your spouse, birth certificates for your biological or adopted children, and other court documents showing child custody or guardianship. 

If you don’t have official documents on hand, please take the time right now to request them from the appropriate state or county records departments. Sometimes it takes a while to get them. And you don’t want to stress about it or miss the deadlines. 

Who Is Considered an Eligible Dependent?

Eligible dependents include:

  • A spouse under a legal marriage recognized by the state of Maryland or other state in the U.S.
  • An unmarried/married dependent child regardless of student status until the end of the birth month in which he or she reaches age 26.
  • An unmarried/married Dependent child who is incapable of self-support because of mental or physical incapacity that began before the child reached age 26. Proof of incapacity must be received by HCPSS within 30 days after coverage would otherwise terminate. Additional proof of disability may be required from time to time.

Who Is Considered a Dependent Child?

  • Biological children
  • Legally adopted children or children placed in the employee’s home pending final adoption
  • Stepchildren who permanently reside in the employee’s household and are dependent on the employee for more than half of their financial support
  • Foster children (provided the foster child is not a ward of the state)
  • Children who are under the legal guardianship of the employee
  • Children for whom the employee is required to provide health care coverage under a recognized Qualified Medical Child Support Order

Can I Cover My Ex-Spouse If They Were Covered On My Plan While We Were Married?

Under no circumstances may an ex-spouse be covered under your employee benefits. Ex-spouses must be removed from the plan. If a divorce document states that you are required to provide health insurance coverage for your ex-spouse, that coverage may not be under your HCPSS employee plan. Ex-spouses qualify for COBRA, and will be made an offer of COBRA coverage upon terminating from the plan.

How Can I Remove A Dependent Who Is No Longer Eligible?

If you are unable to provide qualifying documentation for any of your currently covered dependents we are offering an amnesty period where you may remove those dependents in Workday without documentation or consequence.  This period will run from March 13 to March 24, 2023. See attached for directions on how to remove these dependents in Workday.

Failure to remove ineligible dependents from your benefits plan during the amnesty period may result in one or more of the following consequences:

  • Retro-termination of benefits 
  • You becoming liable for medical, pharmacy, dental and/or vision claims previously paid by HCPSS
  • Formal disciplinary procedures

 

The goal with this early announcement is to give employees plenty of time to prepare for the dependent eligibility verification audit coming in April 2023. Everything you need to complete this process will be mailed to your home address in April.

Questions about this process may be directed to the Benefits Office at 410-313-7333 or by email at Benefits@hcpss.org.