New York State to audit state employees', retirees' dependents to ensure eligibility in health care plan

The New York state Department of Civil Service this fall is planning to launch an investigation to ensure that the 1.2 million state employees, dependents and retirees who receive health insurance under the New York State Health Insurance Program are eligible for their coverage, the Albany Times Union reports.

According to the Times Union, thousands of people receiving coverage though the program might not be eligible, such as former spouses and adult children.

According to the Times Union, because of the large number of families enrolled in the program, "insurance experts have long suspected that a large number of employees continue to improperly keep" ineligible people listed as dependents. Department spokesperson David Ernst said, "There's no easy way to police that sort of thing."

While the cost of the investigation in unknown at this point, it likely will result in greater savings from removing ineligible dependents, according to Ernst.

The program costs the state $6 billion annually. Policyholders will have a two-month grace period to remove ineligible dependents without penalty once the audit begins. Policyholders who retain ineligible people on their plans could face civil or criminal penalties, and could be required to refund premiums (Karlin, Albany Times Union, 9/3).