More than 1,800 people have been removed from the state-employee health insurance program after Gov. Rick Scott’s administration started requiring workers to fork over tax documents and their children’s birth certificates to verify that family members qualify for coverage.
Nina Ashley, a spokeswoman for the state agency that oversees the health-insurance program, said decisions to terminate coverage have been made by people who were enrolled.
“No one at this point has been dismissed by us,’’ said Ashley, who works for the Department of Management Services.
Florida’s push to require employees to hand over personal information is part of an audit that was authorized by lawmakers after being suggested by the Scott administration.
Ashley said that since the audit began five months ago, 1,825 dependents have been dropped from the health-insurance program.
The Scott administration last year touted the audit as an “industry-best practice” and said it was necessary to “ensure that taxpayer dollars are correctly invested.” When it was first recommended, the Department of Management Services said in a news release that the audit would save $45 million.
Those savings, however, have yet to materialize. With the audit nearly complete, the state is pegging the savings at closer to $9.5 million.
Employees who don’t submit required documents or knowingly submit false information about dependents may be required to reimburse the state for insurance premiums or paid claims, according to a state website explaining the audit. Those employees also could be subjected to “disciplinary action,” according to the website.
Lawmakers agreed to authorize the audit in 2017 as part of budget negotiations and allowed the department to hire a contractor to carry it out.
The Legislature also listed documents that state employees could be required to submit as part of the audit, including tax documents and birth certificates. But lawmakers did not mandate that the documents be provided.
Health Management Systems, a Texas-based firm that is being paid $950,000 to perform the audit, sent a letter to employees demanding that they submit birth certificates to verify the eligibility of children and IRS tax-return transcripts to verify marriages.
Ashley told The News Service of Florida the department was “following the spirit of the law.”
Florida AFL-CIO legislative and political director, Rich Templin disagreed, saying the audit was “sold as voluntary.”
Templin is concerned with the direction the state is taking in the health-insurance program, which is considered benefit-rich. Templin said benefits are often what keeps state employees on the job.
“Our concern is, it’s being chiseled away,” he said.
Florida will spend $2.7 billion next fiscal year on the employee health-insurance program, which covers everyone from lawmakers, the governor and Cabinet members to state university professors and judicial employees. Benefits are available to active employees and retirees as well as their dependents.
More than 136,000 full-time state employees chose to enroll in the insurance plan during the last open-enrollment period, according to the state. The majority of those employees, or about 56 percent, enrolled in family coverage. About 40 percent enrolled in an individual plan and the remaining enrolled in a spouse plan.
Another 5,540 part-time employees enrolled in the insurance program during the last open-enrollment period. The majority of those employees enrolled in the individual plan, but about 1,900 chose to enroll in a family or spouse plan.
The program allows employees to cover children, whether biological, adopted, stepchildren or foster children, as well as any children they are legally responsible for, through age 26.
Some adult children through age 30 can continue to be covered under certain circumstances. Employees can also include coverage for dependents’ newborn children for upward of 18 months so long as the state was notified within two months of the birth.
Under the audit process, employees married for more than one year were directed to submit transcripts of their most recently filed federal income-tax returns. Recently married employees who didn’t file joint returns were required to provide marriage certificates.
Health Management Systems launched the first phase of the audit late last year sending letters to employees at 14 agencies, with the letters saying, “In order for your dependents to continue to receive benefits … action is required by you to submit proof of their eligibility.”
Ashley said the overall compliance rate for those employees was more than 97 percent. The second phase of the audit ended this week, and the compliance rate for employees at those targeted agencies was more than 96 percent.
While the compliance rate is high, the state hasn’t heard back from all employees. But Ashley said the state has not removed any dependents because of failure to provide the documents.
Employees in the third phase of audit have until May 10 to submit the required paperwork, Ashley said. To date, the compliance rate with those employees is about 43.7 percent.
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