We Have the Answers

A:

Your employer needs to ensure that only eligible dependents are covered under their plan(s). It is important that employers use strong fiscal management to control benefit costs by excluding dependents that are not eligible to receive those benefits. Ineligible dependents enrolled in benefit plans increase costs – both for you and for your employer.

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No. BMI is an independent auditing firm that has been hired as a third-party to verify the eligibility of your group plans. BMI will provide your employer with an analysis of all received documentation in order to verify the records are current and accurate.

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While all audits are different, the most commonly requested documents are:

Spouse:  

a copy of a marriage license or a marriage certificate to verify your legal spouse. A joint document may also be requested. Joint documents must be dated within the last 90 days and address to both parties. Examples of joint documentation include: Utility Bill, Mortgage Statement, Auto Insurance Statement, or Property Tax Statement.

Dependent child:  

a copy of a birth certificate or court document that identifies one or both enrolled parents. The employee or enrolled spouse must be identified with the child or other additional supporting document may be required. A hospital birth record may be accepted as long as it contains this information and is signed by either the attending physician or hospital administrator.

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Most commonly, you can obtain a copy of a birth certificate or marriage certificate from your county or town clerk’s office. Most court records can be obtained directly from the courthouse. However, if you do not live in the location where the event occurred or are unable to visit the office, please see the below suggestions:

  • CDC Vital Statistics Website (www.cdc.gov): This website allows you to choose the state you are attempting to obtain a document from and gives additional information about who to contact.
  • Vital Records Guide (www.vitalrecordsguide.com): This is another website in which you can choose by state to find information on how to obtain a document.
  • VitalChek (www.vitalchek.com): Many states use VitalChek as a clearinghouse for requesting documentation. For a small fee, you can obtain copies of your records.
  • U.S. Department of State (www.state.gov): If your child was born out of the United States to U.S. citizen parents, you may be able to obtain a copy of the Consular Report of Birth through the U.S. Department of State.
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No. Neither BMI nor your employer will reimburse you for costs associated with obtaining documentation for your audit.

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While a notation does exist on some documents, this refers to making copies to use as legal purposes. When making a photocopy of most documents, a watermark ‘VOID’ will appear in the background of the document. BMI also recommend writing “Not for Official Use” on any document to further confirm your document cannot be used for any legal purpose.

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The simple answer is that BMI has entered into an agreement as to acceptable documentation for each type of dependent who is eligible on your group plan. See below for specific answers as to why we cannot accept certain documentation.

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Unfortunately, no. The purpose of the audit to verify the relationship, and while the document will prove your identity; it will not verify the relationship.

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No. Some employers may allow former spouses to remain on coverage. If your employer does not have specific plan language supporting the coverage of your former spouse, then they are to come off your plan at the time of the final judgment of your divorce, regardless of the language included in your divorce decree.

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BMI is considered a "Business Associate" under HIPAA regulations since we perform functions and activities on behalf of "Covered Entities" who are Plan Administrators and Plan Sponsors of employer group Health Plans. As a business associate, BMI receives protected health information when providing services, but maintains a contractual obligation with your employer to protect this information and adhere to HIPAA privacy and security regulations. BMI will never request an ORIGINAL or CERTIFIED COPY of a birth or marriage certificate. A photocopy or fax of a document is not a legal document and it cannot be used to obtain any other personal form of identification. BMI does not outsource the handling of your audit. The BMI audit staff is all housed in one office location in a secure and locked environment which requires a key or passcode to enter the rooms where your documents are receive and stored. Computer access to your audit file can only be accessed with an individual auditor password. The audit process, staff training, and office structure are all designed to protect your personal information.

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You can submit your documentation one of three ways:

  • Secure Web Portal: Visit www.bmiverify.com and click on the ‘Upload’ tab to submit your documents in the quickest and most secure way.
  • Digital Fax: Fax your documentation to 855-301-3030. Please ensure that you verify that all pages have been sent to the correct fax number successfully by checking the fax transmittal report. Be sure to keep a copy of this transmittal report.
  • Mail: Submit documentation in the postage paid envelope provided with the initial mailing or by sending to BMI Audit Services, PO Box 989, South Bend, IN 46624.
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Absolutely! BMI’s web portal is optimized for both smartphone and tablet usage. Click the ‘Upload’ tab and once you select ‘Browse’, it will open your photo gallery. Choose the photos you wish to submit and they will be securely sent to BMI through the portal.

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Unless you have given BMI a telephone number, all communications, including requests for additional information, will be made in writing or via email if you have inquired through audit@bmiaudit.com.

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BMI will receive your audit response and process the information within three business days. You can check the status of your audit by visiting the BMI Web Portal (www.bmiverify.com) anytime or you can contact our call center (877-634-7780) during our business hours. If your documents are received before an audit closes, you will be mailed a postcard when your audit response is received and is complete and you will be mailed a letter if your response is incomplete.

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You may write a note on your verification form and BMI will send the corrected information to your employer.

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No. You may not add eligible dependents as part of this verification process. Please contact your HR support team.

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If any of your listed dependents are no longer eligible you may call BMI, or you can indicate on the Dependent Eligibility Verification form that the dependent is to be dropped from coverage. You must write in a specific explanation of why they are no longer eligible and the date their eligibility ended. BMI cannot accept requests for changes to your benefit if the change is a qualifying event. If a qualifying event has occurred, you should immediately contact your HR support team so that you can provide the information required and review your available options.

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It is your responsibility to provide acceptable proof of eligibility for dependents enrolled in your employers benefit plan. It is important that you follow the instructions and respond with the required documentation by the due date outlined in the packet. If the required documentation is not received by a deadline your employer will review dependents that have not successfully completed the verification program requirements and they may choose to drop their benefits from coverage. Knowingly covering ineligible dependents is unacceptable and, for a number of reasons, can lead to unfavorable tax and legal consequences for you, your employer, and the ineligible individual.

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Your employer will review the information you have provided to BMI and they will consider your reported eligibility answers. BMI does a second review of any ineligible audit finding to assure that a second auditor’s consideration has been made of your response. If you believe the information you provided was inaccurate you should call BMI and discuss your concern. Every effort is made to assist you in continuing eligibility of your verified and eligible enrolled dependents.

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If you have a translation of the document, please submit it. BMI has the ability to translate many languages. We will try to translate the document, however, if we are unable to translate your document, we will ask for a word-for-word translation. We prefer this translation to be through a certified translator; however, it is not a requirement.

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Each employee who receives an audit packet is required to respond if they wish to continue to cover their enrolled dependents. Failure to respond or providing incomplete or inaccurate information may cause you to lose benefit coverage for your unverified dependent(s). If you provide inaccurate, incomplete, or false information your signature of attestation on the audit form confirms your acceptance of responsibility for your actions and your employer may take appropriate disciplinary action. If you send no response your employer will assume you are unable to verify the eligibility of your enrolled dependent and they may remove them from benefit coverage.