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Take Heed: October 4 Deadline for City's Dependent Health Care Coverage Audit

In June, the City of New York initiated an audit of dependents covered by the NYC Health Benefits Program, asking for documentation to verify the eligibility of dependents covered under the plan. The PSC and other City unions, which did not approve the audit, sought some guarantees of fair procedure, and have now won some changes.

October 4 is the new deadline for submitting documentation. No one should ignore this audit. The PSC is strongly urging all affected bargaining unit members to submit the requested documents; if you do not, you risk losing health coverage for your dependents.

Consulting Firm

The current audit began in June, when a private consulting firm contracted by the City sent out more than 300,000 letters to municipal employees (including full-time CUNY employees) and retirees under the age 80 who have dependents currently covered on the City’s health insurance plan. The letters described the audit, what documents are being requested and what actions employees must take.

While the unions in the Municipal Labor Committee (MLC) made clear that there was no opposition to the idea that only eligible dependents can be covered, they objected to the City that the process was seriously flawed and are seeking guarantees of fairness and due process. After weeks of trying to push the City to negotiate aspects of the audit process that are mandatory subjects of collective bargaining, the MLC went to court and succeeded in convincing the judge to issue a temporary restraining order.

Since then, the MLC has successfully negotiated terms with the City to protect the rights of employees and retirees with dependents on City health insurance. These include: 1) a written, comprehensive appeal process; 2) protection from financial penalties if employees take “good faith” steps to correct problems; and 3) satisfactory safeguards regarding security and confidentiality. The restraining order has subsequently been lifted, and the City is free to continue its audit.

New Deadline

Some of these newly won protections will largely apply to those who make good-faith efforts to comply by the new deadline of October 4, 2013. Again, no one should ignore this audit. The PSC is strongly urging all affected members of the bargaining unit to submit the requested documents by October 4. If you ignore the deadline, you leave yourself at risk for losing health coverage for your dependents.

Everyone under age 80 with dependents on their policy should have received notice. If you have not, please contact the Employee Benefits Program, 40 Rector Street, 4th floor, New York, NY 10006. The telephone number is 212-306-7200; the fax number is 212-306-7378; the e-mail address is ehbmail@olr.nyc.gov.

Respond by October 4

You can submit materials by mail, fax or e-mail. Do not mail original documents. Even if you are still seeking needed materials, which may not arrive by the October 4, 2013, deadline, be sure to file your response by October 4 anyway, along with a note specifying the documentation you are waiting for and when you expect to receive it.

If you discover that a dependent or former dependent of yours has been covered by City health insurance and should not have been, contact the Employee Benefits Program (at 212-306-7200 or ehbmail@olr.nyc.gov) before October 4, 2013, and remove him/her/them from coverage. If you are not sure, call and inquire. Then submit the requested material by October 4, 2013. Employees who self-report mistaken coverage by that date will not be subject to recoupment of monies incorrectly paid or disciplinary charges.

Above all, respond by October 4, 2013.