If you’re in an urgent situation, the last thing you would want is to learn that a claim is being denied because a person you’ve enrolled doesn’t qualify to be on the plan.
To ensure that all enrolled individuals meet eligibility requirements, we’ve hired an independent audit firm, HMS Employer Solutions, to audit plan participants.
Watch your mail!
New dependents (spouse and children) added to insurance will be audited. You'll receive a notice from HMS via US mail. The notice will instruct you how to submit your documents to validate your dependents. Examples of required documents include government-issued marriage and/or birth certificate, proof of residency, and tax documents.
If you receive an audit notice, HMS is available at 855-615-7291 (5 AM - 5 PM MST, Monday - Friday)
Fax: 877-223-8478 (Be sure to include the reference number indicated on the forms HMS mailed to you on any documents you fax.)
Don’t ignore the request! To ensure continued coverage, HMS must receive the requested documentation by the deadline outlined in the communication they send. Individuals who aren't verified through the audit processed will be removed from coverage, and you may be required to pay back money paid for insurance claims. Adding dependents who don't meet requirements may result in employment discipline up to and including termination of employment.