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Pensions and Benefits

State Health Benefits Program and
School Employees' Health Benefits Program

DEPENDENT ELIGIBILITY VERIFICATION AUDIT (DEVA)

Frequently Asked Questions


Q. Why are you asking me to verify my dependents?

A. To ensure plan compliance with New Jersey law, we must guarantee consistent application of eligibility requirements within the SHBP/SEHBP’s health plans. Additionally, ineligible dependents that are using our health plans create higher costs for those who are eligible. We realize that, in the majority of situations, the ineligible dependents are covered due to an oversight. For example, you may not have updated your benefit information following a divorce, or you may have a child who was previously eligible but now exceeds the age limit. Regardless of the circumstances, we are conducting a Dependent Eligibility Verification Audit to bring our dependent information up to date and monitor it going forward.

Q. Which dependent types must be verified?

A. All eligible dependent types (Spouses, Civil Union Partners, Domestic Partners, Children, Disabled Dependents, and Continued Coverage for overage children) must be verified to maintain coverage for these dependents.

Q. Why is the State conducting the audit now?

A. The State has a fiduciary responsibility to ensure that only eligible dependents receive benefits under the SHBP/SEHBP. In the past, periodic reviews of dependent eligibility have been conducted for randomly-selected members but staffing constraints had limited the scope of these audits. Subsequently, a recent audit of the SHBP/SEHBP by the Office of Legislative Services recommended that the Division of Pensions and Benefits require documentation supporting the eligibility of dependents covered under the SHBP or SEHBP. Therefore, we are conducting the audit to bring our dependent information up-to-date and to ensure that only dependents who meet the SHBP/SEHBP’s eligibility requirements are covered.

Q. Why was Aon Consulting selected to assist with the audit?

A. Aon Consulting is currently the health benefits consultant to the SHBP and SEHBP. There are a number of services Aon provides to the SHBP, one of which is conducting a variety of audits.

Q. What do I have to do now?

A. Read the enclosed information and complete the Affidavit Signature Form, providing required documentation, in its entirety, including phone number and dependent relationship. You must also sign and date the Affidavit Signature Form for it to be valid. This Affidavit Signature Form is a legal document on which you attest to your dependents’ eligibility or ineligibility to participate in the SHBP/SEHBP. Refer to the enclosed Eligibility Definitions and Documentation page Adobe PDF (65K) to determine if your dependents are eligible or ineligible. Once you submit your completed Affidavit Signature Form, with required documentation, via the self-addressed, postage-paid envelope included, no further action is necessary by you unless you are contacted by the SHBP/SEHBP Dependent Eligibility Verification Audit Unit. 

Q. Do I have to provide my Social Security Number?

A. No. You will be asked to verify other pertinent information such as date of birth and address. You may also be asked to provide a portion of the barcode numbers located at the top of your letter.

Q. What happens if I fail to respond to the Dependent Eligibility Verification Audit?

A. The SHBP/SEHBP will have no choice but to terminate your dependent(s) coverage if you do not provide the required documentation to verify eligibility.

Q. What will happen to my dependents’ coverage once I complete the Affidavit Signature Form and send in required documentation?

A. The dependent(s) listed on your Affidavit Signature Form whom you declared as ‘eligible’, and verified with appropriate documentation, will continue to be covered with no lapse in coverage. Dependents deemed ‘ineligible’ through this audit will be terminated from the SHBP/SEHBP on the date indicated in the package of materials you have been provided. 

Q. What happens to my documents once received by Aon?  What does Aon have in place to ensure the security of the documents?

A. As soon as documents are scanned and success of scanning is verified, hard copies of the documents are destroyed. Accordingly, please do not submit original documents and keep copies of everything you send back. Only select personnel have access through a secure password to the documents and viewable images of the documents.  Scanned documents will be forwarded to the Division of Pensions and Benefits.

Q. My co-workers have received correspondence from Aon.  Why haven’t I?

A. The audit is being conducted in phases with each phase containing up to four stages over the next 18 months. The SHBP/SEHBP’s participant population is broken up into stages according to health plan, coverage level, etc. NOT by employer location. Therefore, all employees will not receive letters from Aon simultaneously.

Q. Who do I call if I have questions concerning correspondence received for the dependent audit?

A. The Aon DEVA Call Center closed on Monday, August 9, 2010.

You may send correspondence to:

Dependent Eligibility Verification Audit
Health Benefits Bureau
Division of Pensions and Benefits
PO Box 299
Trenton, NJ 08625-0299

Q. I misplaced my letter.  Where do I send my documents?

A. If you lost your entire packet, do not copy a fellow employee’s packet. Each employee is assigned a unique number for security purposes.

The Aon DEVA Call Center closed on Monday, August 9, 2010.

You may send correspondence to:

Dependent Eligibility Verification Audit
Health Benefits Bureau
Division of Pensions and Benefits
PO Box 299
Trenton, NJ 08625-0299

Q. What are the options for continuing coverage for ineligible dependents?

A. Termination of an ineligible dependent who was not eligible for coverage is not considered a COBRA Qualifying Event. In certain circumstances, where an eligible dependent became ineligible within the last 60 days, COBRA may be offered. Please contact the SHBP/SEHBP Dependent Eligibility Verification Service Center for clarification regarding possible continuation of coverage for such dependents. 

Q. If I’m notified that my dependents will be terminated, what are my options?

A. If your dependents were terminated and you feel that they meet the eligibility requirements of the SHBP/SEHBP and you have submitted all verifying documentation, you may appeal to the Commission governing the SHBP or SEHBP. A detailed explanation of the reason for your appeal and supporting documentation should be sent to:

DEVA Appeals Coordinator
Division of Pensions and Benefits
PO Box 299
Trenton, NJ 08625-0299

The Aon DEVA Call Center closed on Monday, August 9, 2010.

 
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