The North Carolina State Health Plan is constantly working to provide the best return on investment as well as reducing complexity and building value for all of its members. As an important step towards managing costs, the State Health Plan began conducting an audit in 2017 that required all subscribers with dependents under the age of 75 to submit documents to confirm the eligibility of their dependents. That audit process is now complete. During this audit period, the State Health Plan successfully confirmed the eligibility of 186,477 dependents, or 99 percent of the audit population.
Plan members were informed of the audit through letters and postcards mailed to their home, e-newsletters and phone calls. Documents were accepted via the upload feature in the Plan’s enrollment system, email, fax and mail. In addition, from August 2017 through January 2018, subscribers who had not responded, or tried to respond but submitted invalid documents, were given extra time to comply.
Moving forward, there will be additional documentation required to verify dependent coverage when a new employee enrolls in benefits at UNC. Additionally, all qualifying life events will require supporting documentation and approval; and newborns being added to employees’ plans will require an uploaded birth certificate within 30 days of birth, as well as a Social Security number within six months.Learn more