OEBB Dependent Eligibility Verification Review
Frequently Asked Questions and Answers
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1. Why is OEBB conducting a dependent eligibility review?
OEBB is required by rule (OAR 111-080-0055) to complete a dependent eligibility review for each entity participating in OEBB at least once every three years.
Having ineligible dependents enrolled in the benefit plans is a significant issue that affects the overall cost of health care coverage as well as what you pay in premiums. OEBB has a responsibility to ensure that your health care dollars are being used appropriately. This review will help to monitor the plan eligibility requirements and ensure only eligible dependents are enrolled in the benefit plans.
OEBB’s goal with this process is to verify that only eligible dependents are covered on the OEBB benefit plans. This process will help us effectively manage your benefit plans’ costs so we can offer you the highest quality plans at the lowest possible cost.
3. How do I complete the verification process?
To complete this process, you must verify the eligibility of each of your dependents by submitting or providing acceptable documentation. You can do this one of four ways:
1. You can mail copies of your documents to OEBB along with your completed Certification of Dependent Eligibility Form.
2. You can fax copies of your documents, along with your completed Certification of Eligibility Form, to our secure fax number at 503-378-5832.
3. You can bring your documentation to your entity’s on-site review. The date, location, and time of the on-site review is listed on the instruction letter from OEBB. OEBB staff will be at this location to review and log your documentation..
Note: The Certification of Dependent Eligibility Form is mailed to members at the beginning of the review process.
If you choose to submit your Certification of Dependent Eligibility Form and required documentation by fax or mail, please allow five to seven days for processing faxes and seven to 10 days for processing mail. You may check the status of your submitted documents by calling OEBB at 1-888-469-6322.
4. How can I get a copy of my dependent’s birth certificate, marriage certificate, or other records?
Copies of birth certificates and other personal vital records can only be obtained from the state where they originally were filed. Some resources for obtaining documents:
· National Center for Health Statistics through the Centers for Disease Control – Information for all states can be found at http://www.cdc.gov/nchs/w2w.htm
· U.S. Department of State - A Consular Report of Birth can be obtained by writing to the U.S. Department of State for individuals born abroad to U.S. citizen parents. Visit http://www.state.gov for more information.
· Internal Revenue Service - A free transcript of a federal tax return can be obtained by contacting the local IRS office. Local contact information is available at www.irs.gov.
· Oregon Center for Health Statistics (CHS) is where you can obtain certified copies of birth certificates and other vital records in Oregon.
5. My child’s birth certificate states copies should not be made. Should I submit an original?
No. You should submit a copy.
Photocopied birth certificates are not considered a valid form of identification for state or federal government uses (e.g., state identification card, driver’s license, passport, etc.).
Because the OEBB dependent verification process is not a government process, photocopies of birth certificates are considered an acceptable form of documentation of dependent eligibility. If you are using a birth certificate to certify eligibility, be sure to only submit copies, not the original.
6. Do I need to complete the dependent verification process if all my dependents are eligible?
Yes. OEBB is required to complete a dependent eligibility review for each entity at least once every three years. If your entity is scheduled to complete their review, it is mandatory that you verify and submit acceptable documentation by deadline for your entity’s review date. A review schedule for the current calendar year can be found on our website at: http://www.oregon.gov/oha/OEBB/entity/Pages/eeDEVReviews.aspx
7. What happens if I don’t complete the dependent verification process by the review deadline for my entity?
If you have been selected to complete the verification process, it is critical that you provide the appropriate documentation for your dependents by the review deadline. Failing to complete the verification process will result in any listed dependent’s loss of coverage.
8. If I don’t have any dependents enrolled, do I still need to complete the dependent verification process?
OEBB members selected for this process had at least one dependent (spouse, domestic partner or child) showing in the MyOEBB system at the time of your entity’s review. OEBB will need to receive the appropriate documentation for each dependent listed in MyOEBB. If you currently do not have anyone listed as a dependent in MyOEBB and you receive a letter from OEBB indicating you have dependents in MyOEBB, please contact OEBB Member Services by phone at 1-888-469-6322 or by e-mail at firstname.lastname@example.org.
9. How will I know if my completed Certification of Dependent Eligibility Form was received?
A formal confirmation statement that confirms the eligibility status of your
dependent(s) will be sent to you within two weeks after all of your dependents are processed.
10. If I have questions about the dependent eligibility review process, who should I contact?
If you have questions about the dependent eligibility review process, eligibility requirements, or forms of acceptable documentation, you may contact OEBB by phone at 1-888-469-6322 or email at email@example.com.
11. If I have already submitted my Qualified Medical Child Support Order (QMCSO) to confirm that my dependent is eligible for OEBB’s coverage, will I need to complete and return the Certification of Dependent Eligibility Form?
Yes. You are still required to complete and return this form to verify and confirm the accuracy of the information. QMCSO verification is a separate process from the dependent eligibility verification process. It’s important for you to verify whether your dependent is eligible for OEBB’s benefit plans so his or her coverage is not affected.
12. What if a dependent I recently added to my health care coverage is not listed on the Certification of Dependent Eligibility Form?
The data used to compile the Certification of Dependent Eligibility Form was pulled the date your entity’s review began. If your dependent’s coverage was added after this date it would not be indicated in your materials. You only need to provide documentation for the dependents listed on the Certification of Dependent Eligibility Form.
13. What if the list on the Certification of Dependent Eligibility Form showing my dependents has inaccurate information about my dependent such as name or birth date?
If you find inaccuracies in the information listed for your dependents, please complete the Certification of Dependent Eligibility Form and submit your documentation for the review along with a description of the inaccuracy. OEBB will follow-up to identify whether additional information or documentation is necessary.
14. Is this process confidential?
Yes. All information you provide for the dependent eligibility review will be kept confidential. OEBB will shred all documents you provide at the conclusion of the review for your entity. No documents will be retained. That is why it is especially important for out to provide OEBB only copies of the documents.
15. What happens if my dependent is determined to be ineligible for OEBB plans?
Dependents identified as ineligible will be terminated from all OEBB benefit plans effective the last day of the month in which the determination was made and no later than the last day of the month in which the review is completed. COBRA continuation information will be mailed to you indicating the exact date coverage ends and COBRA eligibility begins. More information on COBRA and other insurance alternatives can be found on the OEBB website: http://www.oregon.gov/OHA/OEBB/Pages/faq/COBRA.aspx