State Health Plan Dependent Eligibility Verification Audit Under Way!

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State Health Plan Dependent Eligibility Verification Audit Under Way!

State Health Plan Dependent Eligibility Verification Audit Under Way!

The State Health Plan recently announced strategic priorities and benefit changes designed to provide Plan members – including retirees – with stability and predictability in their health plan benefits. These changes also begin the task of lowering the state’s $43 billion in unfunded liabilities for retiree health benefits.

Allowing ineligible dependents to participate in the Plan increases the overall cost of our Plan to members and taxpayers.  As an important step towards reducing costs and eliminating waste, the Plan is conducting an audit to verify eligibility of dependents covered by the Plan. This audit will focus on all subscribers with dependents under the age of 75 as of April 19, 2017.

In order to ensure continued coverage under the Plan for those dependents, members must respond with the required documentation by July 31, 2017. Failure to respond and produce the required documentation will result in termination of dependents’ coverage under the Plan effective August 1, 2017.

Members should have already received a letter with a request to provide documentation of their dependents, which will need to be provided by July 31, 2017. Members will need to upload the required documents using the Document Center in eEnroll, the Plan’s online enrollment system.

Retirees access eEnroll via the ORBIT system. Visit www.shpnc.org and click Enroll Now and select the yellow button to access ORBIT.

Click here to view a complete listing of the Dependent Eligibility Verification Audit Required Documents.

Members that do not have access to eEnroll can email their documents to SHPDependentAudit@benefitfocus.com or fax them to 866-742-6444. Members who email or fax documents are required to include their Full Name, Dependent’s Full Name, State Health Plan ID number located on their Plan ID card and the name of their employing unit (if any) on both the email and fax in order for the document to be accepted. Mailed, hard copy documents will not be accepted.

Members with questions about this process should contact the Eligibility and Enrollment Support Center at 855-859-0966, Monday through Friday, between 8 a.m. and 5 p.m. EST.

For complete details, including step-by-step uploading instructions and frequently asked questions, visit the Plan’s website.

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