DEPENDENT ELIGIBILITY VERIFICATION Agency Benefit Coordinators Training for the State of Ohio July 2

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DEPENDENT ELIGIBILITY VERIFICATIONAgency
Benefit Coordinators Trainingfor the State of
OhioJuly 29th and 30thAugust 4th, 6th

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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

• 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 states 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, contd
• Each Verification Packet includes Verification
  Letter, Verification Form, Definitions and
  Required Documents, FAQs and Postage-paid Return
  Envelope
• Secovas toll-free call center (24/7) opens to
  answer participants 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

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Tools for Managers/HR

• FAQs 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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VerificationCompliance Support
Participant Communications and Support Services
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Dependent Eligibility Communications

• Clear and frequent
• Communication 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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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 participants
  verification status
• View project communications online
• View real-time reports on entire verification
  project

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Document Review

• Where to Look
• What to Check
• How to Identify Fraud
• Secova has an experienced team of document
  processors that are professionally trained to
  audit, identify variants, and ensure validity of
  documents.

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Dependent Verification
VERIFICATION REVIEW IS DEFINED FOR EACH DEPENDENT
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Security Top Priority
Secova offers peace of mind with top-level
security SAS 70 Type II certification

• 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

• 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 Were 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
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Thank You
Secova, Inc. 5000 Birch Street Suite 300, East
Tower Newport Beach, CA 92660
1.866.257.0011www.secova.com