Page 17 - Work Force September 2016

Dependent eligibility verification audit enters final stage
NYSHIP’s dependent eligibility verification project for those enrollees with family health insurance is entering its final
stage. This project impacts all NYSHIP enrollees with family health insurance (The Empire Plan and NYSHIP HMOs). The audit will help ensure that every participant who receives NYSHIP health benefits is entitled to those benefits.
HMS Employer Solutions (HMS) was the vendor selected to perform this eligibility audit, which is similar to the dependent verification audit conducted in 2009. In early July, HMS mailed a verification letter to Active New York State NYSHIP enrollees with Family coverage (Phase 3).
The deadline to respond and submit proof of eligibility for
covered dependent(s) was Aug. 19, 2016 (please note the Grace Period extension). It is very important
that enrollees respond by the
Grace Period deadline or their dependent(s) will be removed from coverage retroactively to Jan. 1, 2016.
Phase 3 – New York State Employees with family coverage:
• Active employees of New York
state: July 5 – Aug. 19, 2016
Phase 3 verification period ended on Aug. 19, 2016. Please note: NYSHIP has allowed a brief grace period for enrollees to submit verification to HMS Employer
Solutions (1-866-252-0635) until Sept. 7. Due to time restraints, it is encouraged that documentation be submitted by electronic web upload at VerifyOS.com or fax the documentation to 1-877-223-8478.
Note: The verification periods for Phase 1 (active and retired local government, town and municipal employees, etc.) and Phase 2 (active and retired authority employees and New York State retirees) are now complete. Individuals trying
to appeal dependents previously removed during Phase 1 or Phase 2 of the eligibility audit can contact HMS at 1-866-252-0527.
Data breach impacts CDPHP and
BlueCross BlueShield of Western
NY enrollees
CSEA has been made aware that a data breach occurred with the ID card vendor for NYSHIP Health Maintenance Organizations, Capital District Physicians’ Health Plan (CDPHP), and BlueCross BlueShield of Western New York.
The data breach is still being investigated, however, we wanted to make the following information (which was available at the time of press) available to our membership:
On Aug. 5, 2016, Newkirk Products, Inc., a service provider that issues healthcare ID cards
for numerous plans, including CDPHP and BlueCross BlueShield
of Western NY, offered through NYSHIP, announced a cyber-security incident involving unauthorized access to a server containing certain personal information.
The server did not contain Social Security numbers, banking or credit card information, medical information or any insurance claims information.
Letters to those impacted by the incident have begun to be mailed. These letters include an explanation of the incident, an offer of two
years of free identity protection and restoration services and information about additional ways impacted individuals can protect themselves.
To learn more about this data breach incident or get answers to frequently asked questions, contact the Newkirk assistance line directly at 1-855-303-9773 (TTY/TDD: 711), Monday - Saturday, 9 a.m. – 9 p.m. or newkirkproductsfacts.com.
September 2016
The Work Force 17