requesting documentation

Irie

Do any of you request further information from employees when they complete their enrollment applications? I'm speaking of marriage certificates to prove the employee is legally married, proof of student status, a creditable coverage statement for a late enrollment? Our carrier does not do this but places the responsibility on us to get this information and I'm wondering if anyone else is required to do this. Thanks.

SMace

We aren't required to do it. But, we do it anyway. We are just finishing a period where we required proof documentation from any dependent enrolled on the plan.

Sounds like you are self insured. If you have a very large claim, I bet your reinsurer will want eligibility proof. If they find out they aren't eligible they will not pay. Then who is stuck with the bag. There would be a valid argument that you had a fiduciary duty as plan administrator to verify proof of eligibility.

Although it is difficult to administer all the paperwork, I think it is the right thing to do.

Irie

Actually we aren't self insured. We're contracted with UnitedHealthcare and they will not verify eligibility (along with a lot of other things I feel they should be doing but won't). Their premiums were the lowest for us but they refuse to do things like send out certificates of coverage and other miscellaneous participant information. They won't even change an address for a participant who calls customer service. All of that has been dumped on me.

SMace

Do you have a broker?

I don't think they can refuse to send out certificates of coverage, can they?

I guess you get what you pay for. Sorry.