Audit of BLET members' eligible dependents continues

Over the past several months, Aetna has been conducting an audit of eligible dependents and requiring employees to submit proof of eligibility for their dependents to continue uninterrupted health-care benefits. As of April 14, 2008, the dependent eligibility audit has been passed on to United HealthCare to finish the final stages of the audit.

Those employees who failed to respond to the Aetna portion of the audit have had all of their dependents' coverage terminated (medical, dental, mental health and substance abuse, vision and prescription drug), effective April 15, 2008. Any employee who made a recorded attempt to supply some documentation for dependent verification, but were unable to provide all needed documents to clear their dependents' eligibility, have had the incomplete dependents' dental-only benefits terminated, effective April 15, 2008. Among the documents members may have to provide as part of the audit include a marriage certificate, children's birth certificates, or proof of enrollment for dependents attending college.

All employees who fall into either of the above categories should have received a letter in the mail from United Healthcare documenting their dependent's current loss of benefits status. Dependents who have had just their dental benefits terminated due to the fact that they were partial responders will have until June 30, 2008, to provide the remaining proof of eligibility in order to have their dependent's dental benefits restored. If they fail to provide sufficient documentation by the end of the 60-day time period allotted, then their dependents will not only continue to not have dental coverage but all other coverages will be terminated as well (medical, mental health and substance abuse, vision and prescription drug).

The other part of the audit that UHC is working on is to audit any dependent who was not included in the first phase of the audit performed by Aetna. The snap shot date for the information used by Aetna, in the beginning stages of the audit, was all dependents who had coverage as of April 2007. United HealthCare is following the audit up by auditing any dependent who was added to the policy between April 2007 and the present. Any employee who has a dependent in this category should have received a mailing from United HealthCare asking for documentation for proof of eligibility of their dependents and will be given until October 31, 2008, to comply with the notice or have all dependents' benefit coverage terminated.

If you have received notification that dependent coverage has been terminated or if you have had recent problems with your dependents' coverage, immediately call United HealthCare at (800) 753-2692 in order to obtain information about reinstating those eligible dependents.

 

© 2008 Brotherhood of Locomotive Engineers and Trainmen