Closer look: Dependents' health insurance eligibility verification procedures vary among state's universities
14 03 08 - 11:15
By DAN SCHNEIDER, DMG Writer
HOUGHTON - Michigan Technological University's requirements for verifying an employee's spouse or dependent is eligible to receive university health insurance benefits are similar to some universities in the state while other universities have more rigorous requirements.
In the midst of a years-long trend of escalating health insurance costs nationwide, The Daily Mining Gazette surveyed six of Michigan's 15 public universities to determine how Tech's verification requirements stacked up against those of its peer institutions.
At Tech, when an employee enrolls in the university's health insurance program and signs a spouse, child or designated eligible individual up for benefits, the employee certifies the other person's eligibility with a signature on the bottom of the enrollment form. Tech does not require the employee to provide documents, such as a marriage license or birth certificate, proving the other person's eligibility.
Neither do the University of Michigan, Northern Michigan University or Grand Valley State University.
At Western Michigan University, employees must provide a marriage certificate to prove a spousal relation, or a birth certificate to prove a child's eligibility.
Employees at Michigan State University are required to provide a marriage license to verify a spouse's eligibility, and fill out and affidavit annually to certify the spouse is still eligible for benefits. A birth certificate is required to verify a dependent child's eligibility, or a hospital certificate if a newborn's birth certificate is not yet available. In both cases, the university allows tax forms as temporary verification if it will take time to obtain a copy of the other documents.
Ellen Horsch, Tech's vice president for administration, said Tech's procedures meet legal requirements without adding to the university's already lengthy employee orientation process.
"We're going to do things that are required by law to verify employment and provide our fringe benefit package," Horsch said. "The main point is that why would we put additional steps in if it's not necessary if it's complicated enough?"
Dave Reid, U of M's director of communications for university human resources, said in an e-mail that collecting and maintaining eligibility documentation can become a significant expense for a university.
"When limited financial resources are used to provide benefits for ineligible individuals, it reduces the resources available to provide high quality benefits for our employees and their eligible family members," MSU Interim Assistant Vice President for Human Resources Chris Hanna said in a prepared statement. "Verification of benefits eligibility is one way we ensure that all the funds we expend on health care directly benefit our employees and their eligible family members."
Though Northern Michigan University and Grand Valley State University do not require marriage licenses or birth certificates at the outset of employment, if an employee later adds a spouse or dependent to his or her insurance coverage, the employee must provide appropriate documentation.
At Tech, spouses and dependents can be added to insurance at a later time using verification by signature. At U of M, the same signature or electronic certification suffices for spouses or dependents added later to an employee's insurance.
Tech Director of Human Resources Sherry Kauppi said employees can be disciplined, up to and including dismissal, for making false statements or misrepresentations on their health insurance enrollment forms. However, Tech's internal auditor, Amy Hughes, said that has not been a problem in her 15 years in that position.
"Periodically, we do detailed benefits audits and in our tests we have never found that issue," Hughes said. "We do sample testing ... we don't generally go beyond that unless we have any suspicions."
Hughes said benefits audits are not part of Tech's annual auditing process, but occur at irregular intervals.
"When we think that enough time has passed or a risk is there, we do them again," Hughes said.
In an e-mail, Reid said at U of M "to date, our audits have revealed no pattern of misconduct ..."
Horsch said Tech analyzes its employee compensation package, including health insurance benefits, on an annual basis "to see what is appropriate to attract and retain faculty."
Policies are set each year prior the start of Tech's open enrollment period in November.