benefitsFOCUS: Ongoing Medical Plan Dependent Eligibility Reviews Begin in May

Over the spring and summer of 2023, we required all employees covering dependents on our medical plan at that time to complete a Dependent Eligibility Review process. The review was conducted by Part D Advisors (PDA), an independent cost containment firm that specializes in conducting eligibility reviews. The purpose of the review was to ensure that all dependents enrolled on our plan met eligibility guidelines for coverage. All employees, retirees, and COBRA participants on our health plan who covered spouses/children were required to complete this process, which wrapped up in September. Since that time, all new dependents on the plan have undergone the same review process.

Beginning this month, PDA will begin random spot audits of dependents enrolled on our medical plan with the goal of reviewing all of our covered dependents at least once in a 3-year rolling period to ensure that we are continuing to cover eligible dependents in a fair and equitable manner. As with last year’s review process, selected employees will receive mailings at their home, informing them of the need to complete the review process. Responses to the verification request can be made via web portal (which can also be accessed via smartphone) or via U.S. Mail. This letter will contain personalized login information, along with a toll-free phone number that will connect employees with PDA’s verification team for assistance with questions or accessing the portal. Employees who are contacted by PDA are required to complete the verification process in order to maintain coverage on their dependents.

If you have questions about the review process, please contact benefits@k12albemarle.org for assistance.