Bill Calls for Verification of State Employee Health Plan Dependents
The California Legislature has passed a bill (SB 98) that would require state employers to verify the eligibility of dependents on current and retired employees' health plans, the Sacramento Bee's "The State Worker" reports. The bill now heads to Gov. Jerry Brown (D).
Background
SB 98 was introduced after a 2014 CalPERS audit found that 9,000 individuals had been improperly listed as dependents eligible for state health coverage. In total, more than 14,000 wrongly insured dependents were removed from the state's insurances rolls after state workers and retirees voluntarily removed 5,300 ineligible individuals during an amnesty period before the audit.
Ineligible dependents included those who were older than age 25, as well as former spouses and domestic partners.
According to a report presented to the CalPERS Board of Administration, removing the ineligible dependents saved the state:
- More than $2 million monthly in premium payments; and
- $3.7 million monthly on other costs, such as hospital visits.
Details of SB 98
According to "The State Worker," SB 98 aims to clarify who is ineligible as a dependent by explicitly noting, "'Family member' does not include a former spouse or former domestic partner of [a state] employee or (retiree)."
Under the legislation, employers also would be required every three years to collect documentation to "substantiate the continue eligibility" of dependents, including:
- Children;
- Children of domestic partners;
- Domestic partners; and
- Stepchildren.
Meanwhile, verification for other children for whom the state worker or retiree "has assumed a parent-child relationship" would be required at least once annually.
SB 98 also would require employees, retirees and their dependents who qualify for Medicare to switch out of CalPERS coverage (Ortiz, "The State Worker," Sacramento Bee, 6/23).
This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.