Dependent Eligibility Verification Audit

Advance Notice: 2014 CMS Dependent Eligibility Verification Audit

You may be eligible to participate in a health or life insurance plan offered through the State of Illinois Department of Central Management Services (“CMS”). You are encouraged to read this communication carefully if you insure any dependent(s) under a CMS plan.CMS announced the upcoming audit of all dependents enrolled in the health and life insurance plans provided by the State of Illinois. This “Dependent Eligibility Verification Audit” period will begin on January 22, 2014 and end on February 21, 2014.

By law, the State of Illinois can only cover members and their eligible dependents in the state plans. To ensure only eligible dependents are covered, CMS contracted with HMS Employer Solutions (“HMS”) to conduct this Dependent Eligibility Verification Audit. HMS will be requesting that you provide specific documentation to confirm each of your dependents’ eligibility.
Failure to provide the required documentation to HMS will result in termination of your dependent coverage. Per CMS, neither CMS nor the University can forward documents to HMS, nor can they provide you with copies of any previously submitted documents.
What can you do NOW to prepare for the Dependent Audit?
·         If you do not have a dependent covered on one of the University health or life insurance plans (through CMS), you do nothing. 
·         If you do have a dependent covered on one of the University health or life insurance plans (through CMS), please do the following:

  1. Verify that your mailing address is correct on your CMS Benefit Statement at https://cmspublic.illinois.gov/eben
    1. If not correct, update your mailing address in NESSIE at https://nessie.uihr.uillinois.edu/cf/file/info/login.cfm.
    2. If your mailing address is correct in NESSIE but not on your CMS Benefit Statement send an email to benefits@uillinois.edu providing your correct mailing address.
    3. You will receive a verification form from CMS when this update is complete.
  2. Review the documentation that will be required during the Dependent Audit (see table below), and obtain any necessary documents that you do not have readily available.
    1. Please Note: the required documentation differs from documents you may have provided when adding the dependent. For example, a marriage certificate is not acceptable documentation to verify a spouse for the purposes of this audit.
    2. Watch for a letter from the State of Illinois to arrive at your home around January 22, 2014. Here is an image of the return address on the envelope: