Beginning 9/1/2011, documentation must be provided for all new dependents. The specific documentation required from the participant for each type of dependent added can be found on the System Benefits Administration website.
Documentation requirements for existing dependents
- If the dependent is listed on screen 115 with a Verify flag of ‘I’ (Ineligible) or a blank (never verified), documentation is required
- If the dependent is listed on screen 115 with a Verify flag of ‘V’ (Verified), documentation is not required
- If the dependent is listed on screen 115 with a Verify flag of ’T’ (Transferred Coverage)
- with active coverage, documentation is not required
- with no coverage, documentation is required
The participant has the ability to uploaded dependent verification documents to their iBenefits document. As processor, you may also upload documents on the participant’s behalf, but you do not have the ability to delete uploaded documents. Once documents are uploaded, you will have an alert appear on your Processor Home Page.
Pending Verification Lists: There are a couple ways to get a list of your dependents needing verification:
- Clicking the alert link on your Processor Home Page stating “uploaded dependent documents require verification” or hovering over the Participants tab then clicking the “Uploaded Dependent Documents” link.
- This view shows each dependent needing verification separately. So, there could be several dependents listed that belong to 1 iBenefits document.
- Under Document Search, click the “Alerts Search” tab which takes you to the Alerts Search page then choose “Uploaded Documents Verification Required” from the Alert Type drop-down.
- This view shows each iBenefits document that contains dependents needing verification. There could be several dependents needing verification for each iBenefits document listed.
- Additionally, selecting the “Dependent Documentation Required” Alert Type option will give a list of all iBenefits documents that have one or more dependents who have not yet uploaded verification documentation.
More than one document may be uploaded for each dependent. Uploaded documents that do not suffice for verification for eligibility should be rejected by clicking the Reject button. Acceptable documentation may also be marked as such by using the Accept button.
A dependent can be verified without having an uploaded document. For example, if a participant is verifying 3 children and scans all 3 birth certificates into one document and uploads that document to one dependent, all 3 dependents can be verified (assuming documentation is sufficient) from that one document.
When the iBenefits document is Posted (this happens at Initialization for AE docs), an overnight process will move all uploaded documents to the benefit imaging system under the participant’s record. Rejected documents will also be included in the participant’s imaged benefit document list with a document type of “Rejected Dependent Eligibility Verification Documents”.
From the Alert Search page:
- Go to the Benefit Overview of the document then click the Dependents tab
- Click the Upload Documents button next to the dependent to verify
- Click the View button to review any uploaded documentation
- If documentation is acceptable, mark as such by clicking the Accept button. The accept button may be used even if the documentation provided is not sufficient to prove eligibility. For instance, accept a marriage license even if proof of joint ownership is still missing. It is not required, but a comment would be helpful in this situation to state what is lacking.
- If documentation is not valid, click the Reject button. You will be required to provide a comment for all rejected documents. If you wish to contact the participant, click the “Send an Email to the Participant” link to start an email to the participant.
- Once sufficient documentation is attained and reviewed, click the Verify button for the dependent.
From the Participants | Uploaded Dependent Documents page:
- You may click the document number and follow the instructions as described from the Alert Search page above
- If only one document has been uploaded for the dependent, use the fly-out menu to View then Verify or Reject (as appropriate)
- If more than one document has been uploaded, click the View All button to go to the Dependent Documents page to follow the instructions given above.
Process for manually recording receipt of dependent verification documentation
If documentation is received AFTER the iBenefits document Posts to BPP, record the verification date in BPP.
- Look at the iBenefits document, the Confirmation Letter in the imaging system for that document, or the NE Dependents Requiring Documents reports and gather what coverage and start dates the participant indicated for that dependent.
- On the 115 screen in BPP, enter the verify flag, verify date, and coverages to be given to the dependent. (Of course, additional 106 updates may also be necessary – coverage level, number covered, etc.)
- Send documentation to the System Benefits Office for scanning.