The Daily Bulletin

The New York State Health Insurance Program (NYSHIP) is conducting a Dependent Eligibility Verification Audit to help ensure that every participant who receives benefits is entitled to them. Targeted participants include those who are enrolled in a NYSHIP-sponsored plan (Empire Plan, one of the offered HMOs, or Opt Out) who insure or cover a dependent (i.e., spouse, child, etc.).

Verification Phase: July 5 to August 19
Enrollees with family coverage should receive or should have already received a home mailing from HMS Employer Solutions that includes a cover letter and verification form explaining required documentation of eligibility for their dependents covered under NYSHIP. If eligibility was verified for a natural child, a stepchild, or a child of a domestic partner in the 2009 audit, you will not be asked to verify the child's status during the current audit.

Required documentation for any covered dependents must be received no later than Friday, August 19, 2016. The verification form together with copies of all required documents is to be submitted to HMS Employer Solutions. These forms are not to be submitted to Human Resource Management or to the NYS Department of Civil Service. For fastest processing, please submit required documents by uploading them via the web portal or by faxing them to (877) 223-8478. If web and fax are unavailable to you, documents may be mailed to HMS Employer Solutions, P.O. Box 165308, Irving, TX 75016-9923. Please do not mail original documents. If you have any questions, please call HMS (866) 252-0635 from 8:00 a.m. to 11:00 p.m. Eastern Time, Monday through Friday.

It is imperative that enrollees respond and provide copies of acceptable proof of eligibility (such as birth certificates or marriage certificates and proof of inter-financial dependence) in a timely manner during their verification phase. Dependents of enrollees who fail to respond will be removed from coverage retroactively to January 1, 2016. In addition, enrollees may be responsible for repaying all health insurance claims for ineligible dependents as early as the date the dependent became ineligible.