News & Events

Dependent Eligibility Verification Program
Seton Hall > News & Events 

Thursday, April 16, 2009
by: Susan Basso

Consistent with my March 16, 2009 communication, Seton Hall University strives to continually improve financial controls to safeguard the University's resources and prevent fraud. The Department of Human Resources is responsible for ensuring that our benefits program operates according to the terms contained in our policies and plan documents. Dependent healthcare coverage is a valuable and expensive piece of your benefits package. Seton Hall must verify that only eligible dependents are covered under the University's benefits program. Every dollar spent to cover non-eligible individuals has a substantial negative impact on all of us.
 
Thus, Seton Hall is launching a dependent eligibility verification program to ensure that individuals claimed as dependents under medical, dental and tuition remission/exchange programs are, in fact, eligible dependents consistent with University benefits program criteria. The dependent eligibility verification program has two parts: (1) an amnesty period, and (2) a verification process.
 
Amnesty Period
The University is offering "amnesty" to faculty and employees who, either through oversight or perhaps even knowingly, have violated the eligibility rules of the University's benefits program by enrolling individuals as their eligible dependents who do not meet the plan definition of an eligible dependent. Amnesty, as it relates to this review process, means that you will not incur any penalty or punishment for any misrepresentation of dependents.
 
The amnesty period will be six weeks beginning on April 14, 2009 and concluding on May 22, 2009. During this time, faculty and employees who have ineligible dependents included under any University benefits program are strongly encouraged to come forward and disclose the violation to Human Resources. The disclosure will be kept strictly confidential. Your supervisor will not be notified and no questions will be asked. The only action that will be taken is the removal of the ineligible dependent from the University's benefit plan in accordance with the applicable coverage termination provisions in plan documents. The ineligible dependent is not eligible for coverage under COBRA. To take advantage of the amnesty, complete the Dependent Eligibility Amnesty Change form and submit it to Human Resources not later than May 22, 2009.
 
As a reminder, and for your convenience, the Dependent Eligibility for Medical and Dental plans and Tuition Benefits Chart contains detailed information.
 
As always, eligible dependents may be added to our medical and dental plans during the annual, open enrollment period, or within thirty [30] days of a "status change event", such as the birth of a child, a spouse's loss of employment, etc. Supporting documentation verifying dependent eligibility will be required for any dependent added after April 14, 2009.
 
If you have a question or if you are unsure whether you have mistakenly listed an ineligible individual as an eligible dependent for coverage under the University's benefit programs, you are encouraged to contact Ms. Kimberly Mangum at Ext. 9176 for medical and dental, and Ms. Therese Chidiac at Ext. 9606 for tuition remission/exchange.
 
Verification Process
Following the amnesty period, the University's Department of Internal Audit will conduct the verification process.
 
As of April 14, 2009 all faculty and employees claiming a dependent under the University's medical, dental, and/or tuition remission/exchange programs, will be required to provide appropriate documentation verifying dependent eligibility. This means that in order to claim an individual as an eligible dependent, you must first provide documentary proof of dependent status. Please refer to the list of Acceptable Documentation for Dependent Eligibility. Links to obtain these documents and other vital records can be accessed directly below.
 
Access to Vital Records
New Jersey  http://www.state.nj.us/health/vital/index.shtml
Pennsylvania http://www.vitalrec.com/pa.html
New York  http://www.health.state.ny.us/vital_records
National http://www.cdc.gov/nchs/w2w.htm
 
Because Seton Hall has provided an extended self-identification and amnesty period during which faculty and employees may disclose and remove ineligible dependents with no penalty, the consequences for failing to voluntarily disclose violations will be severe. Ineligible dependents that are discovered during the verification process will have their benefits (medical/dental coverage, tuition remission/exchange) terminated in accordance with the applicable coverage termination provisions in plan documents and COBRA will not apply. Faculty and employees who have included ineligible dependents as eligible dependents under any University benefits plan and who are discovered during the verification process will be subject to appropriate disciplinary actions and sanctions, up to and including termination of employment.
 
If you have questions about the dependent eligibility verification program, please contact Ms. Kimberly Mangum at Ext. 9176.  

For more information please contact:
Kimberly Mangum
(973) 761-9176
mangumki@shu.edu