DEPENDENT ELIGIBILITY VERIFICATION

Agency Benefit Coordinators Trainingfor the State of Ohio

July 29th and 30th

August 4th, 6th

Introducing Secova

Our Mission: To help employers control and drive down the

cost of delivering Human Resources & Participant Benefit Services.

Privately held company founded in 1989

Long-term relationships with many Fortune 500 companies

Dedicated Dependent Eligibility Verification team with 10+ years experience

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Rising Cost of Benefits

119%

34%

29%

0%

20%

40%

60%

80%

100%

120%

140%

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Health Insurance Premiums

Workers' Earnings

Overall Inflation

Cost of medical benefits has risen by 151% from 1999 – 2008

Wages have increased 37 % in same period Benefit costs are rising almost 5 times the rate of

inflation

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What is Your Role in this Process?

Information source for participants

Refer participants with questions to Secova. Do not accept documents from them – let Secova do the work.

Promote the message of “shared value” we all have in verifying that only enrolled dependents are covered under the state’s benefit plans

Assist with communications to participants who have not completed the dependent verification

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Project Calendar

Winter – Spring 2009 State of Ohio distributes internal communications to

participants announcing upcoming Dependent Eligibility Verification Project

All employees provided a copy of Dependent Eligibility guidelines prior to Open Enrollment

June - July Project planning commences, project

communications drafted Secova conducts training webinars for Agency

Benefits Coordinators

August Webinar training concludes August 21st - Dependent Eligibility Verification

Packet is mailed to participants

August, cont’d Each Verification Packet includes: Verification Letter,

Verification Form, Definitions and Required Documents, FAQ’s and Postage-paid Return Envelope

Secova’s toll-free call center (24/7) opens to answer participant’s confidential questions, and assist with the verification of eligible dependents, 1-866-372-4519

September September 21st – Reminder Letters mailed

October Secova begins outbound telephone communications

to non-responders October 31st - Last day to submit documentation to

verify dependent eligibility. State of Ohio begins termination of ineligible dependents from benefits coverage

November November 23rd Suspension of Coverage letter mailed

to participants with unverified dependents

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Key Dates

August 21 – Secova mails Verification Packet to Participants – call center opens for participant calls, 1-866-372-4519

September 21 – Secova mails Reminder Letter to Non-responders

October 31 – Document Submission Deadline November 23 – Secova mails Suspension of Coverage

Letter – Reconsideration requests are considered December 15 – Project closes

Tools for Managers/HR

FAQ’s included with all mailings to participants

Answers most frequently asked questions from participants

Reduces anxiety about submitting documents to verify dependents

Additional FAQs included which answer more detailed questions about verification process

FAQs will also be posted on Benefit website www.ohio.gov\benefits

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FREQUENTLY ASKED QUESTIONS Dependent Eligibility Verification

1. What happens if one or more of my enrolled dependents doesn’t meet eligibility requirements as listed in the attached the State of Ohio Dependent Eligibility Definitions and Required Documents?

You must check the “No” box on the Verification Form and your ineligible dependents will be dropped from the State of Ohio coverage. 2. What happens to the coverage of individuals who don’t meet the definition of an eligible dependent?

Dependents who are dropped from the State of Ohio coverage;

May be eligible for COBRA coverage due to a past qualified event (such as divorce, legal separation, or, if the dependent is a child, becoming too old for coverage).

Will receive a COBRA package. However, receipt of the package doesn’t automatically entitle them to COBRA coverage. For example, parents, grandparents, and siblings of employees were never considered eligible dependents under the The State of Ohio plans. As a result, such individuals aren’t eligible for COBRA coverage.

The State of Ohio reserves the right to request documentation proving prior eligibility status — such as a divorce agreement, school registration, or court order — from individuals who enroll in COBRA. 3. If I want to add a dependent to my coverage at a later date will I be required to provide documentation at that time?

You may. The State of Ohio reserves the right to request proof of any dependent’s eligibility for coverage at any time though you may not be asked to provide documentation at the time you enroll your eligible dependent for coverage.

4. My spouse/ domestic partner has a court order to cover his/ her children but the children do not live with us. How does this affect me?

If the children don’t live with you full-time in a regular parent-child relationship, they aren’t eligible to be covered under the State of Ohio plans. The court order is your spouse/domestic partner’s responsibility. However, the children may be eligible for COBRA coverage under the State of Ohio plans.

5. My divorce or separation decree requires me to provide benefits for my ex-spouse. How does this affect me? Your divorced spouse does not qualify as a dependent under the State of Ohio benefit plans. You must notify your Health Benefits Administrator to end coverage for your ex-spouse effective the date the marriage ended. Divorced spouses may be eligible to continue coverage under COBRA. 6. Who can answer my questions about the definition of an eligible dependent?

If you’ve read the State of Ohio Definition of Eligible Dependents enclosure and still have questions, call Secova at [Insert Number]. Representatives are available 24 hours a day, 7 days a week.

VerificationCompliance Support

Participant Communications and Support Services

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Dependent Eligibility Communications

Clear and frequentCommunication to participants is integral to a successful dependent verification:

Internal Announcement Verification Letter Reminder Letter

Utilize Multiple Mediums Provide every opportunity for the message to be received

Direct Mail Phone

Email Web

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Easy-to-Follow Instructions

Bar Coded for Internal Tracking

Detailed participant instructions

List of dependents to be verified

Contact information (phone & email) for follow-up

Participant declaration of accuracy

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By signing this form, I attest that I have reviewed the Dependent Eligibility Definitions and that the information I am submitting is true and accurate. I understand that knowingly providing false or misleading information in this form may result in any or all of the following actions by the State of Ohio: Terminating my employment and requiring me to reimburse the State of Ohio for benefits and expenses.

<Employee Name> <Address 1> <Address 2> <City, State Zip> [Insert Date]

As of the date above, your dependents listed below are enrolled in the State of Ohio health plans. Please review the Definition of Eligible Dependents and confirm that these dependents are eligible for coverage by taking one of the following actions:

1. Visit the State of Ohio Dependent Eligibility Verification Web site at https://verify.secova.com/Ohio for instructions to verify dependent eligibility online; OR

2. Complete this Verification Form, verifying each dependent’s eligibility for benefits by checking the specific Dependent Type and “Yes” or “No” to indicate if the dependent is eligible for coverage.

Review the Required Documents list for each dependent type currently enrolled. Submit the Required Documentation, along with the completed Verification Form to Secova by mail using the enclosed

postage-paid envelope or fax to 1-866-361-9697 no later than November 13, 2009. Please write your name and Employee ID# in the top right hand corner of any document(s) you submit.

If you select “No” or do not respond for any dependent(s) listed below by November 13, 2009 that dependent’s health benefits coverage will be dropped effective [Insert Date].

(Proof of eligibility is required for all boxes checked “YES”)

Dependent Relation Dependent Type (Please check all boxes that apply for each dependent)

Is dependent eligible for coverage?

Suzy Doe Wife Legally Married Common Law Yes No

John Doe Son Biological Adopted Disabled Stepchild

Full-time Student Legal Guardianship Court Ordered

Yes No

Jack Doe Son Biological Adopted Disabled Stepchild

Full-time Student Legal Guardianship Court Ordered

Yes No

Sally Doe Daughter Biological Adopted Disabled Stepchild

Full-time Student Legal Guardianship Court Ordered

Yes No

Signature Date

If you have questions, please call Secova at 1-866-372-4519 (toll-free). (Representatives are available 24 hours a day, 7 days a week.)

VERIFICATION FORM FOR DEPENDENT ELIGIBILITY

Return form to Secova by November 13, 2009 FAX: 1-866-361-9697 MAIL TO: Secova Eastern Service Center

PO Box 7701 Brick, NJ 08723-9906

Employee ID #: a032456789

Contact information Please provide a telephone number at which you can be reached if we have questions about your dependent’s eligibility for benefits coverage.

Telephone: Best time to call: Day Evening E-mail address: (circle one)

Online Support

Dependent Eligibility Verification System™

PARTICIPANTS: Securely submit information

online View project communications

online Check status of verification

process

ADMINISTRATORS Search & view status of

participant’s verification status View project communications

online View real-time reports on entire

verification project

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Where to Look

What to Check

How to Identify Fraud

Secova has an experienced team of document processor’s that are professionally trained to audit, identify variants, and ensure validity of documents.

Document Review

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Dependent Verification

VERIFICATION REVIEW IS DEFINED FOR EACH DEPENDENTDependen

t TypeRequired Documents Secova Verification Process

Spouse Page 1 and signature page of participant’s 2008 Federal Income Tax Return (1040, 1040A or 1040EZ) listing the spouse as dependent; or

Marriage certificate and one of the following:Proof that participant and spouse own a home or other real estate togetherProof that participant and spouse are both listed on a lease or share the rent of a home or other propertyA utility bill listing both participant and spouse

Tax Return Check to ensure document is Federal Tax Return, not State Ensure participant and spouse’s name is entered in the label section Verify that Tax Return is submitted for appropriate year (2008) *Note: Signature or Proof of e-Filing RequiredMarriage Certificate Validity of Document – Marriage Certificate?Authenticity – Does it look official?Confirm participant name under “Groom” or “Bride”Validation of dependent name as spouse on Marriage CertificateJoint Tenancy Proof Document Confirm that both participant and spouse are listed on documentDoes dependent spouse’s name match?Commonality of Address

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Security: Top Priority

ACCREDITATIONS & CERTIFICATIONS

Certified HIPAA Business Associate

Data regulation & privacy training for all Project Team Members, data security audit & process and procedures

SECURE PROCESSES & PROCEDURES

Dedicated & Secure processing room for incoming mail, faxes, scanning & processing

Privacy Protection Policy for all participants & contractors

Access-controlled review of Call Center Coordinators recorded conversations

Secova offers peace of mind with top-level security & SAS 70 Type II certification

INFORMATION SECURITY

Password protected CRM client tracking application & database

Server hosting in a restricted access room on RAID data backing systems with nightly tape backup

All files encrypted prior to transmission

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HIPAA Compliance/PI Security Telephonic Verification

All personal information (PI) is verified at the start of every call to confirm proper contact

User Access Control Applications are user access controlled

Password Protection Email attachments with confidential information are password protected

Clear Desk, Clear Screen Systems are locked and paperwork with confidential information is

locked in desk drawers when not at workstation Documents

Official documents do not leave the office premises Processed documents are shredded

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Call Center Support

1-866-372-4519 Participant Call Line

Live-answer, confidential 24x7 participant advocacy call center to assist with questions and compliance requirements throughout the verification process

Voice support in multiple languages

100% call recording with daily call monitoring

Random call monitoring to track quality of service

Feedback circulated to team leaders

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VerificationOutcomes

Consequences and Support for Plan Members with Ineligible

Dependents

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What Happens When We’re Done

Non-responders and unverified dependents will terminate coverage October 31, 2009.

Secova provides State of Ohio with detailed analysis of dependent population and recommendations for effective management of dependent eligibility going forward.

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Questions

1919

Thank You

Secova, Inc.5000 Birch Street

Suite 300, East TowerNewport Beach, CA 92660

1.866.257.0011

www.secova.com