Why does the State Health Benefit Plan (SHBP) conduct a Dependent Eligibility Verification Audit?
The SHBP, by law, can only cover Eligible members and their Eligible dependents. This dependent eligibility verification audit is necessary to ensure that the health plan is compliant with these laws.
The documentation required contains sensitive data. Is this process secure?
Protecting personal information is a priority to SHBP and ADP. In compliance with applicable U.S. (federal) and state regulations, information and documentation submitted to ADP/SHBP for the Dependent Eligibility Verification Audit is stored, processed and protected by physical, electronic and procedural safeguards.
Will I be penalized or charged any fees for ineligible dependents?
While some members may be intentionally covering ineligible dependents, SHBP believes that many members are simply unaware that their dependent no longer meets the requirements for eligibility. If, as a result of this audit, it is determined that you are covering an ineligible dependent and/or cannot provide documentation as evidence of eligibility, coverage for that dependent will be terminated prospectively, and you will still be responsible for the costs of coverage during the time the ineligible dependent was enrolled in SHBP.
Do I need to send original documents?
Please do not send your original documents. If the document is two-sided or has multiple pages, ensure you copy and submit all pages and both sides of the paper.
I received an email communication about the audit. Will letters also be mailed?
Yes. All communications and updates regarding the audit will be sent to members both via email (if an email address is on file) and physical letters mailed to members’ homes (if you are an Active Member, based on the mailing addresses provided by your payroll location; if you are a Retiree, based on the mailing address provided by the Retiree).
Will I be reimbursed for the cost of obtaining these documents?
No, any charge for obtaining copies of required documents is your responsibility.
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, the ineligible dependent(s) for whom complete documentation has not been submitted will be removed from coverage prospectively, and you will still be responsible for the costs of coverage during the time the ineligible dependent was enrolled in SHBP.
May I provide my documents to my human resources department instead of ADP?
No. The only way to ensure that all documents are received timely, acknowledged appropriately and eligibility is verified is to use the system that ADP is administering. SHBP will consider documents received after the Verification Deadline as a failure to submitted the requested documents (see above FAQ for additional information).
Who should I contact at ADP if I have questions?
If you have any questions or need further assistance, please contact ADP Dependent Verification Services at 1.800.610.1863, Monday through Friday, 8:30 a.m. – 6:00 p.m. ET.