Dependent Verification Program

Wright State University is committed to managing our healthcare plans efficiently.  As part of this commitment, Wright State has retained the services of third-party administrator, HMS Employer Solutions (HMS), to conduct dependent verification programs throughout the year.  
 
New employees who elected to add their dependents to the medical plan or employees who added new dependents to their plan will be required to participate in this program. HMS will review Wright State’s data to determine if dependents enrolled in the medical plans meet eligibility guidelines.
 
Employees required to participate in the verification program will receive a courtesy notification email from Human Resources identifying the need for participation.  Within a few days of the notification, you will receive a letter addressed to your home from HMS Employer Solutions.  The letter will detail the steps and documentation needed to confirm the eligibility of your enrolled family members.  Several different methods will be available to submit evidence of eligibility to HMS Employer Solutions.  All documentation must be submitted to HMS by the deadline indicated in the letter.
 
During active verification periods, employees can contact HMS Employer Solutions at 1-855-361-3595 from 8:00 AM to 8:00 PM Eastern Time, Monday through Friday.  You can also visit the HMS website at www.auditOS.com. If you have any questions about this information, contact Monica Mack, Senior Benefits Analyst, at 937.775.3299 or monica.mack@wright.edu.

Document Requirements

 Dependent Definitions & Document Requirements

 

The following are eligibility rules, guidelines and documentation requirements for enrollment of qualifying dependents in Wright State University’s group benefit plans, including provisions of Federal and State legislation for Adult Children. Documentation will be requested by WSU’s third-party administrator, HMS Employer Solutions.

 

Dependent Relationship

 

Definition of an eligible dependent

 

Document Requirements

Spouse

Your Eligible Spouse as recognized under the laws of the state where you live

A copy of Marriage Certificate

AND

A copy of last year's 1040 listing spouse or a recent document showing joint finances or residence

Domestic Partner

Your eligible registered same or opposite sex Domestic Partner

A completed Affidavit of Domestic Partnership

AND

A recent document showing joint finances or residence

Child

Your child from birth to age 28

Copy of child’s birth certificate confirming the parent/child relationship

Disabled Dependent

Your child age 26 or older who cannot work to support themselves due to mental retardation or physical or mental handicap

Copy of child’s birth certificate confirming the parent/ child relationship

AND

A copy of last year's 1040 listing the child as a dependent

A child is defined as a natural blood related child, step-child, child of your registered domestic partner, legally adopted child or child placed with the employee for adoption, child for which the employee or employee's spouse has permanent legal custody or legal guardianship, or any child for whom you are required by a Qualified Medical Child Support Order to provide health care coverage.

For stepchildren, documentation for your spouse is also required as proof of the child's current relationship to you.

FAQs

Why is this verification program being conducted?

Wright State University is sensitive to the rising costs of healthcare premiums for our employees and feels that this verification is necessary:

  • In order to control premium and claim costs; insurance dollars should only be paid for eligible dependents.
  • As laws become more stringent, dependent verification is an important tool to maintain enrollment accuracy and prevent fraud.
Who is HMS Employer Solutions?

HMS Employer Solutions (HMS) is an independent third-party company that Wright State has contracted with to verify the eligibility of dependents covered under its medical, dental and vision plans. HMS specializes in verifying health plan eligibility and has performed dependent verification programs for hundreds of thousands of dependents for some of the largest employers in the United States.

The verification process includes the handling and proper disposal of sensitive personal information. Experience and expertise are necessary to complete this program carefully and successfully, and to limit the inconvenience to participants.

What types of documentation will be required during the verification phase?

Documents will include items such as marriage certificates, birth certificates, and copies of other documents that validate current relationship status. You will receive a letter from HMS that will detail the specific document requirements to validate each eligible dependent.

Can exceptions be granted to allow my ineligible dependent to stay covered?

No. Only dependents that currently satisfy the plan’s eligibility definition can remain covered.

If the dependent is no longer eligible because of a “qualifying event,” (e.g. divorce, legal separation, child reaches age limit) and you feel they may be eligible for COBRA continuing coverage see your Human Resources representative for details.

What is the consolidated omnibus budget reconciliation act (COBRA)?

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals should contact their Human Resources representative for COBRA details.

What is the fastest way for me to complete the audit process?

Step 1: Review the verification letter to determine what information is required to validate ALL eligible dependents.
Step 2: Locate and make copies of ALL necessary documentation. Copies should be legible, black and white copies. Include the Reference Number in the upper left hand corner and black out any social security or personal information.
Step 3: Document upload is available online at www.AuditOS.com, or you can fax Documentation to 1-888-938-6161. Use the back of the verification letter as the cover sheet when faxing all documents.

To ensure security, our electronic fax service will load documents into our application securely; no paper is generated using the document upload or fax submission methods. You may also mail your documents using the envelope provided. To expedite Documentation Verification-DO NOT USE COLOR PAPER, STAPLE, HIGHLIGHT, or TAPE any of the documents.
 

What happens if I do not submit all required documents by the verification deadline?

If you fail to provide or knowingly submit false information for enrolled dependents by the Verification Phase deadline–one or all of the following actions may occur:

  • The ineligible dependent(s) and/or dependents for which complete documentation has not been submitted will be removed from coverage.
  • Wright State may seek to recover all claims paid during the period that the ineligible dependent was covered.
  • You may be subject to disciplinary action.

Wright State is ultimately responsible for determining how best to handle each individual case.
 

May I provide the documents to Wright State's Human Resources?

No. Wright State’s Human Resources will not forward documents to HMS nor will they provide employees with copies of previously submitted documents.

The only way to ensure that all documents are logged appropriately and eligibility is verified is to use the system that Wright State has set up through HMS. Please do not call the Wright State Human Resources with questions or for assistance with the verification program, as this is an independent audit.
 

I do not have the documents that are required to verify my dependents. What should I do?

If you do not have the documents required to verify the eligibility of your dependents please contact HMS Employer Solutions to see if there are acceptable documentation alternatives.
 

Will I be reimbursed for the cost of obtaining these documents?

No, any charge for obtaining copies of required documents is your responsibility.
 

What are my options for submitting documentation to HMS?

Document upload on the secure website: Log onto www.AuditOS.com using your reference number and your date of birth. Your reference number can be located on the top right hand corner of the letter that you received. Once you have accessed the site you should click the “My Documents” tab. You will then see the “Browse” button. After you locate your
file and successfully upload it you will receive a pop-up box confirming that your upload was successful.

Fax: HMS’ toll-free fax number is 1-888-938-6161. You may fax your documents 24 hours a day, 7 days a week.

Mail: Documents can be mailed to the Dependent Verification Center, P.O. Box 1587, Jeffersonville, IN 47131. Please allow 5-7 business days for your documents to be received and an additional 5 business days for documents to be processed.
 

The documentation required contains sensitive data. Is this process secure?

Protecting personal information is a priority to Wright State University and HMS. In compliance with applicable U.S. (federal) and state regulations, information and documentation submitted to HMS for the dependent verification program are stored, processed and protected by physical, electronic and procedural safeguards. When submitting marriage certificates, birth certificates and other documents, please mark each document “Not for Official Use”. This notation stipulates that the documents be used only for the purposes of
verifying the eligibility of your dependents. When submitting your tax documentation, only the top portion which includes the names of employee, spouse and any dependent children is required. Please blacken out the social security number, as well as any income information.

All documents are securely stored for six months following completion of the verification program. Upon expiration of the retention period, all documents and electronic files will be securely destroyed by HMS and a Certificate of Destruction will be supplied to Wright State University. Please note that documents provided will NOT be returned. HMS meets all of
the professional and legal standards associated with providing service to employers, including the Health Insurance Portability and Accountability Act (HIPAA), Employee Retirement Income Security Act (ERISA), and disposal rules as enforced by the Federal Trade Commission. In addition, every employee of HMS submits to a thorough and multi-tiered background check. Only HMS employees directly involved in the Wright State University dependent verification program will have access to these documents.