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State Health Plan to Conduct Dependent Eligibility Verification

All State Health Plan subscribers who have dependents covered under the State Health Plan will receive a letter from Secova that details the verification process and lists the dependents covered by the State Health Plan during the 2010-2011 Plan Year. The letter will also outline the required documentation (birth certificates, marriage certificates, tax returns, etc.) that must be provided to confirm dependent eligibility.

Members will be asked to complete and submit a signed Verification Form to Secova, along with the appropriate documentation, by October 15, 2010.  Members may submit the documentation in one of three ways:

  1. By mail (only copies should be sent) to:
    Secova Eastern Service Center
    PO Box 1901
    Wall, NJ 07719-9966, or
  2. By fax, to 1-866-239-5947, a secure electronic fax service operated by Secova, or
  3. Via web upload, by scanning and uploading the documentation to Secova’s Dependent Eligibility Verification secure website: https://verify.secova.com/NorthCarolina
    Please note that in order to log into the website you will need your Member ID#. It is included on the Cover Sheet for Dependent Verification document that is in your Verification Packet. Using the example below the Member ID# is the set of numbers and letters (beginning with W) that appear in the green box. For example the Member ID # in the example below is W1111111101.

    id card sample

All information provided will be kept confidential. Paper documentation provided by subscribers will be shredded when the verification process is complete. For this reason, it is important that subscribers send only copies – not original documents – as verification.

Members who submit a properly completed form and provide acceptable documentation will receive a personalized confirmation letter from Secova; no further action will be required. Members who do not submit a properly completed form and/or do not provide documentation by August 30, 2010, will receive a reminder letter about the approaching dependent verification deadline.

Finally, a suspension of coverage letter will be sent to members who do not respond to the dependent verification request by October 15, 2010. This letter will inform members that their dependents will be dropped from coverage, retroactive to July 1, 2010.

Members whose dependents are removed from coverage may file an appeal. The deadline for filing an appeal is December 15, 2010. Note: Members covering ineligible dependents will be asked to pay for any claims incurred by their ineligible dependents on or after July 1, 2010.

Who is an Eligible Dependent?
An “eligible dependent” of a covered employee is:

  • A legal spouse;
  • An unmarried child under age 26 including natural, legally adopted, foster children, children for whom the employee is a court-ordered guardian and stepchildren of the employee, as long as the employee is legally responsible for such child’s maintenance and support;
  • An unmarried child who is physically or mentally incapacitated, to the extent that he or she is incapable of earning a living, and such handicap developed or began to develop before the dependent’s 26th birthday. 

For More Information
For more information about the dependent verification effort, members may review the Frequently Asked Questions or contact Secova, beginning July 30, 2010, at 1-888-541-8123 (toll-free).