Insurance eligibility in doubt for many dependents

Health: State to check members

BRAD SHANNON; The Olympian | • Published September 17, 2009

Comments (0)

About 6,700 dependents of state employees could lose their state-subsidized health care coverage early next year if they fail to prove eligibility, state officials say.

Letters were sent this month to 330,000 people who have health insurance under Washington’s Public Employees Benefits Board plans, state Health Care Authority spokesman Dave Wasser said.

State employees, retired state workers, retired teachers and others covered under the plans must show proof by Nov. 30 or lose coverage for dependent children or spouses.

“We’re looking at about 4.5 percent as the average we can expect to have of people ineligible who are receiving coverage,” Wasser said, noting that spouses and dependents make up about 149,000 of the total insured. “That’s based on what other people have experienced” in other states such as Montana or businesses such as Weyerhaeuser or Boeing, he added.

Wasser had no estimate of cost savings, but the benefit board’s four-page letter to employees said the program “spent about $1 billion on health care” on the employees’ behalf in the past year. “This new process will ensure that we use taxpayer dollars more fairly and consistently to only cover eligible dependents,” it said.

A state audit recommended the checks on eligibility a few years ago. The audit questioned the status of students who no longer were enrolled at universities but continued to have coverage, said Mindy Chambers, spokeswoman for the state Auditor’s Office. But Chambers said the auditor never asked the Health Care Authority to require tax or Social Security numbers.

Wasser said the agency already has received dozens of calls from concerned workers, and the state will shred any tax documents it receives within 60 days of entering the data into state computer systems. He said the reviews won’t be annual, but the state might do this again in a few years.

“People are concerned about this. For the most part, the calls are concerned about the situation with security. That’s a very valid concern,” Wasser said. “We are taking all the steps we can to ensure that these (tax forms) will be destroyed once we get the information, and (we are) encouraging them to redact the sensitive information themselves before sending it to us.”

The letter to employees says spouses need to show a tax return or both a copy of a marriage certificate and proof of common residence such as a shared utility bill, mortgage note, or the like.

But workers are asked to provide a copy of only the first page of their Form 1040 federal tax returns – after blacking out financial data and the Social Security numbers of dependents. Workers only have to leave the last four digits of their Social Security numbers as identifiers, Wasser said.

Domestic partners can qualify for coverage if they are on the state’s domestic-partnership registry and can show proof of common residence.

Those not eligible will be removed from coverage, and no fraud is assumed, Wasser said, explaining that the state has “very complex eligibility rules. People aren’t always aware of the rules.”

Brad Shannon: 360-753-1688

bshannon@theolympian.com

www.theolympian.com/politicsblog