1. Why do I have to submit a valid SSN to SHBP for my dependents?
Per State Rules and Regulations Chapter 111-4 of the State Health Benefit Plan (SHBP), members and dependents are required to have a valid Social Security Number (SSN) to enroll in and continue coverage. This is not a new requirement. Additionally, SHBP must request SSNs to meet our reporting requirements and to assist our medical vendors and employers with meeting their reporting requirements to the IRS on the applicable 1095-B or 1095-C Forms pursuant to the Patient Protection and Affordable Care Act (PPACA).
2. What happens if I enter an invalid SSN?
Certain number patterns are immediately identified as invalid in the SHBP Enrollment Portal and members who attempt to enter these invalid numbers for their dependents will be prevented from enrolling.
3. What happens if I enter an invalid SSN that is accepted by the SHBP Enrollment Portal?
SHBP monitors the Enrollment Portal on a daily basis to identify dependents currently enrolled with an invalid SSN or no SSN on file to ensure only eligible dependents are enrolled in coverage. When it is determined that a member has provided an invalid SSN or has failed to provide a SSN, the coverage for the dependent(s) will be terminated if a valid SSN is not provided in the time allowed referenced in the initial notification letter.
4. What notification will I receive if I enter an invalid SSN?
Members will receive at a minimum one letter reminding them to provide a valid SSN at least 45 days prior to termination (i.e., the initial notification letter). Members should follow the directions in the initial notification letter to submit their dependent’s SSN to SHBP. (Refer to FAQ 8).
5. What if I fail to provide my dependent’s SSN after SHBP mails me the initial notification letter?
If no valid SSN is provided within the time allowed in the initial notification letter, your dependent’s coverage will be terminated on the last day of the month following the date provided in your initial notification letter. You will also receive a final termination letter reminding you that your coverage is being terminated for failure to provide the SSN by the time allowed in the initial notification letter.
6. When should I provide the SSN for my newborn?
Since newborns do not have a SSN at the time of birth, their SSN must be provided to SHBP no later than when the dependent turns 12 months to prevent coverage termination. Failure to do so will result in termination of coverage on the last day of the 12th month of age. For example, for a child born on July 5, 2017, if no SSN is provided to SHBP, the member would receive an initial notification letter at or around age nine months (i.e., March 5, 2018). If the member still does not provide a valid SSN, the member will receive a final termination notification letter at or around 11 months of age (i.e., May 5, 2018) reminding you that your dependent’s coverage is being terminated for failure to provide the SSN by the time allowed in the initial notification letter. For details regarding reinstatement, refer to FAQ 10.
7. Does SHBP require the actual SSN card or a copy of the SSN card?
No. SHBP does not require an actual SSN card or copies of a SSN card for coverage. Therefore, neither actual SSN cards nor copies of SSN cards will be accepted.
8. How can I provide SHBP a valid SSN for my dependent?
Members should provide their dependent’s SSN by entering it directly into the SHBP Enrollment Portal (https://myshbpga.adp.com/shbp/) or by calling SHBP Member Services at 1.800.610.1863, Monday through Friday, 8:30 a.m. – 5:00 p.m. ET and Saturdays, 8:00a.m. – 5:00 p.m. ET (except holidays).
9. If my dependent’s coverage is still active, can I provide a valid SSN to avoid their coverage being terminated?
Yes. For active members and retirees who provide a valid SSN for their dependent(s) prior to termination, SHBP will cancel the scheduled termination once the Member provides a valid SSN. Refer to FAQ 8.
10. Can I reinstate my dependent’s coverage after SHBP terminates them for failure to provide a valid SSN?
An active member whose dependent has lost coverage due to providing an invalid SSN or failing to provide a SSN, can have his/her dependent’s coverage reinstated by providing a valid SSN (Refer to FAQ 8). Active members can also add a dependent to his/her coverage following a Qualifying Event or during Open Enrollment. If added during Open Enrollment, the dependent’s coverage will become effective on January 1 of the new plan year. If a retiree’s dependent(s) is terminated, the dependent(s) is no longer eligible for SHBP coverage unless there is an applicable Qualifying Event, or the retiree returns to work in a benefits eligible position with a SHBP Employing Entity.
Note for Active Members Participating in Annual Open Enrollment and Retiring Prior to January 1st: retirees are not allowed to add dependents to their coverage except pursuant to an applicable Qualifying Event. This means retirees can continue the same coverage in effect while an active member but cannot add dependents to his/her coverage upon retirement unless permitted as part of an applicable Qualifying Event.
For example, an active member that is planning on retiring effective January 1, 2019 (with his/her last date of employment prior to January 1) and the member currently covers his/her spouse and not his/her child. If the member chooses to add his/her child during the 2018 Open Enrollment for the 2019 Plan year, the member’s child will not be included on his/her retirement coverage. This is because coverage will only include those dependents on the member’s coverage as of the last date of employment (i.e., the Member’s Spouse and not his/her child).
Note for Active Members and Retirees Adding Dependents Due to a Qualifying Event: If a dependent’s coverage is reinstated due to a Qualifying Event, the member still must provide a valid SSN.
Note for Active Members Adding Dependents During Open Enrollment: If a dependent’s coverage is reinstated during Open Enrollment, the member still must provide a valid SSN.
11. What is the effective date of coverage for my dependent who was previously terminated for failure to provide a valid SSN?
Upon an active member providing a valid SSN, SHBP will reinstate the dependent's coverage back to the termination date so there is no break in coverage.
Note SHBP Member Services cannot accommodate requests to have a break in a Dependent’s coverage
Timeframe for requests to reinstate coverage after termination: Please note, SHBP Member Services cannot automatically reinstate coverage for Dependents who have been terminated. Once an Active Member contacts Member Services via phone, the reinstatement process can take up to 30 calendar days from the request. Therefore, it is recommended that Members provide a valid SSN for their Dependents when initially enrolling them in SHBP coverage (or for newborns, as soon as an SSN is available and no later than 12 months of age).
For requests for reinstatement prior to termination, refer to FAQ 9.
12. How much will it costs to reinstate my dependent who was previously terminated for failure to provide a valid SSN?
Active members are responsible for paying all premiums owed retroactively back to the date their dependent lost coverage. If an active member would rather not pay the retroactive premiums to reinstate their dependent, the active member may wait until the next annual Open Enrollment period or a Qualifying Event to reinstate their dependent’s coverage. Refer to FAQ 10.
13. Will providing a document as part of the Dependent Verification Audit process that contains a dependent’s SSN (e.g., tax return for the Marriage Qualifying Event) fulfill the requirement to provide a valid SSN?
No. Dependents whose coverage is terminated due to providing an invalid SSN or no SSN are not eligible for coverage even if they passed the Dependent Verification Process as they have failed to provide a valid SSN to SHBP.
14. What steps can SHBP take if I provide an invalid SSN or fail to provide an SSN to SHBP?
As noted above, dependents with invalid SSNs can have their coverage terminated. Please also refer to the SHBP Eligibility & Enrollment Provisions for information on fraud and intentional misrepresentation.
15. What if my dependent does not have or cannot obtain a social security number?
SSNs are not the only Taxpayer Identification Numbers (TIN) accepted by SHBP. The most common type of TIN is an SSN, but for individuals who are not eligible for an SSN, members may submit an Individual Taxpayer Identification Number (ITIN) or an Adoption Taxpayer Identification Number (ATIN). More information can be found on the Internal Revenue Service’s website by clicking here.