DEPENDENT ELIGIBILITY VERIFICATION
FREQUENTLY ASKED QUESTIONS (revised 7/20/09)

General Information
 1. Why has the state hired Secova to do this dependent eligibility verification project?
Increased health insurance costs are a problem for employers and employees nationwide and the state group insurance program is no exception. Other states and private sector companies that have conducted verification projects have found that, either through a misunderstanding of or misrepresentation of eligibility requirements, their plans were paying insurance claims for ineligible people. By law, our plans can only cover eligible members. While most members are eligible, some dependents in the plans may no longer meet the eligibility rules. So, we need to check the eligibility of all dependents in the plans to make sure the plan is not paying claims for ineligible people. This will help us to keep our premiums affordable.
 2. Who is Secova?
Secova is a privately held company headquartered in Newport Beach, California with additional offices in New Jersey and India. Secova is a highly respected benefits administration services provider specializing in dependent eligibility verification. They have more than 20 years' experience and provide benefits administration and call center services to more than 60 employer groups.
 3. How did the state select Secova?
Following standard State of Tennessee procurement guidelines and rules, the Department of Finance and Administration, Division of Benefits Administration issued a request for proposals (RFP) to over 15 organizations nationwide with the experience and ability to actively manage our dependent eligibility verification process successfully. Two proposals met the state's requirements and were scored. An evaluation team worked independently of each other to score each proposal on the basis of qualifications, experience, and technical approach. The contract was awarded to Secova on the basis of their combined qualifications, technical approach and cost.
 4. Who should I send my Verification Form and Required Documents to?

 
 Mail to: Secova Eastern Service Center     
              PO Box 7701
              Brick, NJ 08723-9906
 
  Phone:   1-877-793-3589 (toll-free)
  Fax:       1-866-621-2160 (toll-free)
  URL:       https://Verify.secova.com/TN
 
 5. What will Secova do with my documents? Will my personal information be safe with Secova?
Yes, your personal information will be safe with Secova. But, please do not send original documents to Secova, only photocopies. When Secova receives your paper documents, they are scanned to an electronic image. This image will be stored on a secure system with password-protected access. Your confidential documents are secure. After the verification is complete, Secova will destroy their copies.
 6. Will I receive confirmation once my verification is complete?
Yes. Secova will mail a confirmation notice once your verification is complete. If your Verification Form or Required Documents are incomplete, Secova will send you a notice that lists what additional information is needed to complete the process.
 7. What happens if I do not return my Verification Form and required documentation before the deadline?
If you do not return the Verification Form and Required Documents by September 4, 2009, your dependent will be terminated from your policy.
 8. What do I need to do if one or more of my enrolled dependents no longer meet one of the eligibility requirements?
You must check the "No" box on the Verification Form and return it to Secova. Secova will remove your ineligible dependent from your policy.
Which Dependents are Eligible for Coverage?
 9. Who can I claim as my eligible dependent?
Please see the enclosed Definitions and Required Documents for details of who is eligible for coverage under the plan.
 10. Who can answer my questions about the definition of an eligible dependent?
Please call Secova at 1-877-793-3589 (toll-free). You can call 24 hours a day, 7 days a week. Your conversation is always confidential.
 11. What is a "full-time" student?
A "full-time" student is someone who is registered for at least the number of credit hours which the institution requires in its definition of full-time student status, and who attends classes for two out of three semesters or three out of four quarters in the most recent 12-month period.
 12. What kind of institution meets the student requirement?
Benefits Administration will recognize it as being an eligible institution as long as it is an accredited (licensed) school, college or university.
 13. My son is between 19 and 24 years of age. He is taking internet classes to earn his degree. Would he qualify as a "full-time" student?
Benefits Administration does not make a distinction between an internet student and one who attends college on a traditionally full-time basis. The institution where the class is being offered must be accredited and the course load must be considered full-time.
 14. My spouse has a court order to cover his/her children but the children do not live with us. Can we cover them on my policy?
Your stepchildren will be eligible as long as either you or your spouse has legal custody, joint custody or a shared parenting plan signed by a judge. They are not required to live with you to qualify for coverage. If they don't meet this qualification, they would qualify if you claim them on your federal income tax return.
 15. If my child gets a divorce, can I enroll him/her under my policy?
Yes, as long as he/she meets one of the dependent eligibility rules. You will have 60 days from the date of his final divorce to enroll him/her without having to have a Special Qualifying Event or go through the Medical Underwriting Process. Please refer to your insurance handbook for more information regarding the Late Applicant Process or contact your Agency Benefit Coordinator.
 16. Can I cover my grandchild(ren) on my policy?
You may as long as your grandchild(ren) lives with you 12 months a year AND you either claim him/her on your federal income tax return, OR you are his/her legal guardian.
 17. Can I cover a relative other than my child or spouse under my policy?
Yes. To qualify, the dependent must live with you 12 months a year and you must claim them on your federal income tax return.
 18. My son attends a military academy (such as West Point, Air Force Academy, and Coast Guard Academy). Is he eligible for coverage under the plan?
As long as he meets one of the dependent eligibility requirements, he is eligible to remain on your policy.
Which Dependents are NOT Eligible for Coverage?
 19. Which dependents are not eligible?
     
  • Children who are married;
  • Foster children;
  • Dependents not listed on the enclosed Definitions and Required Documents;
  • Parents or spouse's parents;
  • Dependent children in the armed services on a full-time basis;
  • Ex-spouses even if court ordered; and
  • Live in companions who are not legally married to the employee.
 20. I misunderstood the eligibility guidelines and have a dependent who is not eligible on my policy. What will happen now?
Check the "No" box next to that dependent's name on the Verification Form and return to Secova. They will remove your ineligible dependent from your policy. During this verification process, the Insurance Committees have agreed to allow a onetime "grace period" for our participants to drop any ineligible dependents without penalty or punishment. In addition, Benefits Administration will not ask you to pay back any claims the plan paid on an ineligible dependent who is removed during this one-time grace period.
 21. How can I get insurance for an ineligible dependent?
Call Secova at 1-877-793-3589 (toll-free). They will help you explore other coverage options. Your conversation with Secova is always confidential. We want everyone to get the right coverage, either through our plan (if they are eligible), or through other options.
 22. My daughter has recently married but still lives with me. Can I cover her under my policy?
No. A married dependent child is not eligible, regardless of his/her age.
 23. My son who is between 19 and 24 years of age has dropped out of school. I will not be able to claim him on my federal income tax return. He plans to go back to college after taking a year off. Can I still cover him under my policy?
No. He is not eligible since he is no longer a "full-time" student or claimed on your federal income tax return.

If a child between 19 and 24 years of age returns to school as a "full-time" student, you can add him/her to your policy. If a child between 19 and 24 years of age becomes eligible to be claimed on your federal income tax return, you can add her/him to your policy. You must complete and return the paperwork to Benefits Administration within 60 days from the time your child becomes newly eligible.
 24. My divorce decree requires me to provide benefits for my ex-spouse. Can I carry him/her on my policy?
No. An ex-spouse is not an eligible dependent under our plan. An ex-spouse may be eligible for COBRA as long as you removed him/her from your state health insurance policy within 60 days of your final divorce.
 25. Can I cover my domestic partner under the State of Tennessee Insurance Program?
No. The State of Tennessee does not recognize same sex marriage, civil unions, or domestic partnerships. The State of Tennessee also does not recognize a same sex marriage, civil union, or domestic partnership granted by another state or jurisdiction.
 26. Will my ineligible dependents be offered COBRA once they are removed from coverage?
A dependent has 60 days to enroll in COBRA from the date he/she loses coverage. If your dependent has been ineligible for more than 60 days, he/she will not be offered COBRA.
 27. My dependent child works for an agency that participates in the State of Tennessee Insurance Program. Can I still cover him/her under my policy?
No. If your child is eligible for his/her own policy under one of the State of Tennessee plans, he/she must be covered by his/her own policy.
  Documentation to Prove Eligibility
 28. The information I received in the mail from Secova states that for a spouse I am to provide "Page one and the signature page of my 2008 federal income tax return listing my spouse as a dependent." You do not list a spouse as a dependent on this form, this information is at the top of the form. What should I do?
In the initial mailing, this was the wording that was included; however, it is not quite accurate. For a spouse, the tax form just needs to list the spouse name at the top of the page and be marked as either married filing jointly or married filing separately.
 29. Can electronically submitted tax returns (such as Turbo Tax) be submitted as verification documentation?
Yes. Please send the signature page and a printout of page 1 of your electronically submitted tax return showing your claimed dependent(s).
 30. I live in a state that has a state income tax. Can I submit the state income tax return instead of the federal income tax return?
No.
 31. Where can I get a copy of my marriage license or birth certificate?
You can request a copy of your marriage license or birth certificate from the Tennessee Department of Health, Vital Records if:
  • You were married within the past 50 years in the state of Tennessee. The first copy will cost $15.00.
  • Your child was born in the State of Tennessee. The first copy will cost $15.00 or you can purchase the short     form for $8.00.
    		•
    If you were married, or your child was born in another state or country you will need to contact them to request a copy.
    Note: The State of Tennessee will not reimburse a participant for the cost of obtaining any documentation required to verify eligibility of their dependents.
     32. Can I blackout my personal and financial data on my federal tax return before submitting it as a verification document?
    Yes. We recommend that you use a black marker to hide personal and financial data and your social security number on the copy of your tax return or other financial documents before submitting them to Secova.
     33. Where can I find my identification number? Is it different from my social security number?
    Your identification number is located on the top right hand corner of the Verification Form. This is not the same as your social security number.
     34. I have just submitted a letter to my insurance company verifying that my child is a "full-time" student. Will I need to complete and submit the Verification Form to Secova?
    Yes. You must submit the required paperwork to Secova.
     35. If I want to add a dependent to my coverage in the future, will I be required to provide eligibility documentation at that time?
    Yes.
     36. I have filed for a divorce but it is not final. Why am I being told I cannot remove this person from my policy?
    Under Tennessee state law, you cannot remove a spouse until after the divorce has become final.
     37. I thought I had single coverage but I have received a request for dependent verification, what should I do?
    Please verify that the dependent(s) listed is not eligible and notify Secova to remove him/her from your policy. The next step you should take is to contact your Agency Benefits Coordinator to verify that you are enrolled in single coverage.
     38. I am only covering one dependent on my policy. If I remove that dependent from my policy, will my coverage level change to single?
    The Service Center will change your coverage to single when the last dependent is removed.
     39. I just recently got married, so we have not yet filed taxes. We also do not have any jointly owned property. All I have is my marriage certificate. What other information can I provide?
    For anyone who was married on or after January 1, 2009, we will accept the marriage certificate only as proof of eligibility.
     40. I just had a newborn and do not have any document other than the birth certificate. What other information can I provide?
    For a newborn, we will accept the birth certificate only as proof of eligibility.
     41. My wife and I are both state employees, so we each have individual coverage. I received a dependent verification form and it shows her listed as a dependent under my policy. Why is she listed as a dependent?
    If a husband and wife are both employed by the state or higher education, they each maintain their own policy as the head of contract. This is done to ensure that each employee receives the maximum amount of basic life insurance available to them. However, if one of you enrolls in family dental coverage and covers the other spouse, this will cause the spouse to be classified as a dependent on the dental plan. In this instance, you must return the verification form and proof of eligibility to continue family dental coverage.
     42. My children are covered under my dental plan; however, they have health insurance under their father's plan. I do not want them added to the state health plan, but want to continue dental coverage. Should I check them as being eligible or not?
    You will need to check them as being eligible for coverage and provide the required documentation to continue dental coverage. We will not add any dependent to any coverage they are not already enrolled in. We are only verifying their eligibility for the coverage they currently have.