WTF? Hubby's employer hired Secova to audit dependent insurance coverage

[54anickel]

In order to perform this audit, Secova is requiring employees who pay for spouse or family coverage to provide proof of relationships and eligibility, including but not limited to income tax forms, marriage certificates, proof of home ownership, and birth certificates.

We sent them a copy of our marriage certificate...not good enough. So, I made a duplicate of our tax return, blacked out the amounts and SS#s, but was just informed by the union steward they have me marked for dropping from the insurance. We need to call and find out wtf is going on.

If I had the $$$ I'd just call a lawyer and be done with it. Since our marital status is a matter of public record. This is a 2nd marriage for both of us, we've only been married since 2005, we do not have any bills in both names. We were 2 separate households under one roof for freakin' 14 years before making it "legal".

I can't believe this is even legal!!! I HATE fucking insurance companies! Found out that if they do drop me, it will cost $$$ to be reinstated, I'll have to fill out a health questionaire and there is the risk that they can turn down covering me.

On edit, found this on their website:

http://www.secova.com/company/news/releases/20090916.asp

NEWPORT BEACH, CA, September 16, 2009 - Secova Inc., a leading provider of human resource and benefits management services, today announced their success in reducing liability for their government clients through dependent eligibility verification resulting in cost savings and compliance with plan rules and fiduciary duties. Based on actual results in the Public sector, ineligible dependents range from 5 % - 15%, resulting in the public sector over spending on total claims costs for their dependents who no longer meet eligibility requirements.

In the 60’s and 70’s Medicare was supposed to cost 4 million, and it ended up costing 5 million. In the 1990’s healthcare grew to be about 12% of the GDP. In 2009 President Obama has reinvigorated the call for universal healthcare. The question is how much is this going to cost? Given the ever increasing nature of healthcare costs (2009 estimated average of $9,552 per employee, an increase of 6% from 2008), there is a clear mandate for tighter controls (Source: Towers Perrin). Further broken down, the public sector spends on average $4,400 per year per dependent enrolled in a healthcare plan. With spiraling health care costs threatening the financial well-being of public institutions, controlling benefit expenses year round is a pressing issue.

Dependent eligibility audits are gaining momentum among the public sector. The bottom line is that dependent eligibility verification has proven itself valuable in identifying ineligible dependents and removing the associated cost to public institutions. On average, Secova’s Public clients realized a savings equal to over 7% of their total claims expenditures, net of the audit costs. As healthcare reform heightens, Secova continues to realign its strategies to adapt to the ever changing healthcare reform. The congressional office is predicting a cost of over 1.4 trillion dollars over the next 10 years marking the need for the public sector to weed out their ineligible dependents to minimize costs.

“Secova’s growth this past year is evidence of the acceptance of our unique value proposition for entry into the public sector. We are extremely pleased to have been chosen as the dependent eligibility audit service provider for such a large number of public entities and see this as a strong indicator of our continued leadership role in the public sector,” says Venkat Tadanki, Co-Founder and Chief Executive Officer of Secova. “Secova draws heavily on People, Platform (technology) and Processes to better drill down on health benefit services for Dependent Eligibility Verification, and for Benefits Administration services."

bit more...

[MichiganVote]

1. We just went through that. Talk about a breach of confidentiality and it was a total hassle.

Hate these bastards.

[54anickel]

4. Hubby has called them before, that's when he was told to send a copy of the tax return. He's going

to call again when he gets back from running for dinner. (I have the freakin' flu!)

Last time he called, he could barely understand the woman - heavy accent. I'd imagine the call center is outsourced overseas...it's available 7/24.

[MichiganVote]

9. Yeah I had to provide three diff. sets of documents b/c every time I called

some other new Indian speaking person who I could not understand told me something different. Finally I told them that if they pulled one more thing out of their ass for me to send, I was going to contact a lawyer. Magically we were approved. Who knew?

AND I meant every single fucking word. I would have gotten a lawyer and I may have to yet since the benefit cycle is about to renew.

Oh and ask them where they are calling from. They told me Canada....:rofl:

[54anickel]

14. Got someone with a sort of British accent, named Lawrence. He told us

everything was verified, but wouldn't give us a confirmation number, tell us what docs were rec'd or e-mail us a confirmation. Nope, just said the system says the spouse has been verified and his manager will be sending something in the mail.

Hubby called back the steward - seems he got some printout from Thursday that said we weren't verified. They are going to rerun the report tomorrow and if it's still not verified he'll call again. We have until Thursday before they start dropping coverage.

There is no real HR department there anymore - nearly everything is handled down in TX. They're going to get as many folks as possible involved by phone tomorrow, including the Union's attorney. He's the one who suggested people request a confirmation number or e-mail---yeah right! That went over real well with Lawrence today.

[MichiganVote]

19. Sounds like exactly what we went through. It was a different company but same game plan.

Its clear this is just another way to dump people. Bastards.

[MiniMe]

2. WTF does home ownership and birth certificate have to do with if you

are married or not??

[54anickel]

3. I guess the birth certificates would be for dependent kids, but the home ownership and

joint bills....I have no idea. Doesn't really "prove" anything - does it.

[SoCalDem]

6. They are trying to rule out "convenience marriages"

where people may be separated, and have different addresses or who may have legally married, but have never shared a household.

Somewhere in the details, is probably a clause that "defines" their version of a "real marriage".

I know many people who have not lived together for ages, but who still have "family" coverage for kids who live elsewhere with a former spouse, or for a spouse who moved out, and has not remarried.

The insurance companies are probably preparing themselves for a harsher definition of what qualifies as a family.... before the rules on them change

[54anickel]

11. It looks like it's all about saving money, never mind what it's costing them to do the audit.

Think about it though - the savings could be enormous, and not just from ineligible dependents.

If they manage to "wrongly" drop a spouse or child with a medical condition, the "new applicant rule" now applies and a person will be required to pay a fee to add them back on because it's not during the open enrollment period. Then there's the health questionaire and maybe an exam...now you have a pre-existing condition and they can simply deny coverage.

At least that's how thing were going down for the United Campus Workers in the state of Tennessee. http://www.unionvoice.org/campaign/fairinsuranceaudit


Google "dependent eligibility verification" it's becoming quite a racket!

[jwirr]

8. Joint bills are used in welfare to prove you live together and not

necessarily marriage status.

[SoCalDem]

12. In many "modern" marriages, each takes care of a part of the bills

and often, the utilities & bills are not IN both names..

These bastards are nitpicking people out of group coverage.., and are setting up new criteria for future "applicants".

Instead of the employee just writing down the names of kids & the wife, they will soon probably require them all to have a physical and prove relationship before any insurance is issued.... and it could all be a part of the HIRING process.

[54anickel]

15. Yep, that would be us. Not a single bill in both names. We did title the last car we bought

in both names...of course a car title wasn't one of the documents listed. You know, that car insurance bill might be addressed jointly....

[SoCalDem]

17. It's funny.. the car my husband drives, is in MY name and the one I drive is in his name

Just laziness on our part, and the fact that both of us were not present when the cars were bought..and we saw no reason to change anything :)

[SharonAnn]

20. Same here. Kind of odd how it worked out.

[jwirr]

21. That would make it harder but I am assuming that most still have one

address that is on a drivers license. This check was developed more to make sure that everyone in the house was listed on the application. Remember if you lie on a welfare application you can go to jail so they are pretty sure we are too afraid to lie. Ha!

[Fridays Child]

5. Secova--I'd like to see them go out of business.

Then their headquarters should be burned to the ground and the earth salted. Fucking carrion eating scum.

[quiller4]

7. Bypass the steward and call your husband's union representative.

Most unions have an attorney on retainer who can put the fear of God into these folks with a call or two. My husband is a retired union rep who had the largest county public employee groups. This nonsese was juststarting when he retired in 2003.

[M0rpheus]

10. The attorney really won't help all that much...

I work for a huge HR outsourcing company (not that one)
There is plenty of incentive for companies to drop 'ineligible' dependents.
These audits happen regularly and are part of reason for the 'May require you to submit documentation regarding your status change' (if they don't require it up front), language.

In an audit I was peripherally a part of (the company I support was auditing dependents - A different dept did the audit portion), HR ended up being the best friend for those screwed over.

Before you go that route, see if you can find a rep who will tell you specifically what you need exactly, in detail. Then ask to speak to a supervisor. Explain what you have sent, what you were told and, ask them to confirm what they received and why it was denied. If it turns out they were wrong to deny you, the sup can fix it quickly. If there was a legit reason, you can get that sup to take up your case and give you a call back once you've sent the required documents.

I've been one of the sups on the business end of that call, they'd really prefer for you to be approved and gone, rather than talking with you every other day.

If you do have to go through HR, Just stick to the facts and be insistent... If you do have a union rep, it COULD be helpful to make sure things go smoothly.

All that said... Good luck to the OP. And remember, the guy on the other end of the phone is just doing his/her job.
:hi:

[dixiegrrrrl]

13. Sounds to me theyare weeding out people who will not fight back.

You say that if they drop you, they will then pre-screen you and charge more to let you back in.
Which would a good reason to drop you.
I suspect they are trying to drop a lot of people who won't argue, then raise rates on those they let back in,
drop those they consider a risk, since apparently current dependents on the insurance did not have all this
prior pre-screening.
They are looking for an excuse to make money off you.
Fight back.
Get a Union Rep.

[54anickel]

16. The Union is involved and it sounds like they are going to fight back. They're fighting just

to keep the damn jobs here and that's not looking too good right now. Fucking company hasn't been the same since Hellaburnin had their grubby paws on it. Has changed hands several times since then.

They are weeding out anyone those that will and will not fight back. Those that are eligible as well as those who are not. Secova gets paid either way...their numbers and bragging rights look better the more they save the company - doesn't much matter to them where those savings come from.

[54anickel]

18. Just think, if we had single payer, universal coverage this would be a mute point.

*sigh*

[snooper2]

22. My company just did this as well...wasn't that big of a deal..

just faxed a copy of our marriage license and all was good.

Talked to someone who works at different company in the same field and he said they had people with their cousins, brothers etc., on health plans.