Greetings,

Health insurance benefits are one of the fastest-growing costs for employers and employees alike. The employer-sponsored health insurance coverage provided through the New York State Health Insurance Program (NYSHIP) is a valuable benefit, however, it is also costly to provide. It becomes more costly for everyone when NYSHIP provides benefits to individuals who are not eligible for coverage.

As many of you are aware, Civil Service Law was amended in 2008 to authorize the NYS Department of Civil Service, the administrator of NYSHIP, to conduct an eligibility audit of dependents under NYSHIP. This endeavor began earlier this year when Civil Service contracted with Budco to complete this task. We are at a very critical stage right now; all enrollees with family coverage must provide proof that each of their dependents is eligible for coverage through NYSHIP. This has caused a lot of stress, confusion and inquiries.

Dependent eligibility verification documentation MUST received by Budco no later than November 25, 2009 to ensure continuation of coverage of covered dependents. If documentation is not received, an enrollee's dependents may be terminated retroactively to February 1, 2009. Other possible consequences of enrollees not verifying eligible dependents include the Department of Civil Service reserving the right to recover payment from the enrollee for claims paid on behalf of any dependent determined to be ineligible and to pursue possible legal action (for those ineligible dependents not removed during the Amnesty Period held earlier this year).

Click on the link below for a listing of frequently asked questions that may be of assistance to you when fielding members' inquiries regarding this Dependent Eligibility Audit. Members should be advised to call Budco directly at 1-888-358-2198 if they have questions regarding the documentation they are required to submit or if they are seeking their dependent eligibility status.

I hope this information is beneficial to you and your members. Although this endeavor is administered by the NYS Department of Civil Service, CSEA is trying to ensure that our members are aware of the requirements, timeframes and penalties in place under this Dependent Eligibility Audit. If you or your members have contacted Budco and still have unresolved questions, please contact the CSEA Health Benefits Department at 1-800-286-5242. This will allow CSEA to be aware of ongoing concerns our members may have.

List of Frequently Asked Questions

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