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“I would appreciate it if they did the right thing.” These are the words of distraught USPS retiree, Teresia Price, who while comparing her substantially lower retiree paycheck with other co-workers, discovered that she had been paying for her two sons’ insurance years after they had become ineligible. The brothers, who are both now in their 40’s, were only just removed from her insurance a year ago, resulting in over $50,000 of overpaid premiums since 1993. An investigation has been initiated to assign responsibility for the overpaid premiums--USPS, OPM, or Blue Cross Blue Shield--all who are pointing fingers at each other.

Obviously, there is a lesson to be learned here in process and communication. USPS clearly didn’t have a thorough process for auditing their benefits which resulted in Teresia and USPS paying a lot of money (for the span of 21 years) for extra dependents that weren’t entitled to receive healthcare coverage. Teresia stated that she “did not notice because I trusted them doing the right thing.”

As a benefits administration company, we help companies do the right thing on a daily basis by using technology to prevent incidents like Teresia’s from happening. How?

Our system has each plan max-age stored so that when a dependent reaches that plan’s specific age, the system automatically moves them from eligible to ineligible status. This automatically triggers our fulfillment center to generate and send personalized documentation to the affected dependent communicating when their coverage will terminate, and why. Once they reach the max-plan age, the system terminates the coverage, and fulfillment automatically sends out the required COBRA information to the dependent who has lost coverage so that they have the proper requirements to continue the coverage if needed.

The best part about this process? A set procedure, clear communication, and a system of record. Removing ineligible dependents not only saves our clients’ money, but also their employees. In Teresia’s case, having the right process in place would have saved her over $50,000 and saved her employer from the negative spotlight.

 

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