Thu
Jul 23 2009
02:04 pm
Protecting Dependent Insurance Coverage at UT
By: cameronjbrooks

The state of Tennessee has hired a private company, Secova, to “audit” dependent insurance coverage for all state employees, including higher education staff and faculty.

In order to perform this audit, Secova is requiring state employees who pay for spouse or family coverage to provide proof of relationships and eligibility, including but not limited to income tax forms, marriage certificates, proof of home ownership, birth certificates, etc. If employees do not return the survey by the deadline of September 4, 2009, or if the documentation doesn’t meet the audit’s standards, dependents will be dropped from coverage. The surveys were mailed out on July 6. The arrival of these surveys come at a time when faculty with 9-month appointments are often away may be away from home during the summer doing research or pursuing their own continuing education. For staff late summer prior to the start of the fall term is one of the few times many campus employees are able to schedule vacations. Additionally, many employees report that the surveys appear to be junk mail upon arriving at their home addresses.

Dependents that are dropped can be reinstated, but there’s a catch – a big one. Requests for reinstatement will be treated as “late applicants,” will be assessed a $75 non-refundable application fee, and will be required to fill out a health questionnaire. Based on the answers to that questionnaire, these so-called “late applicants” may or may not be accepted for coverage.

United Campus Workers calls on the state of Tennessee and its elected officials to do everything they can to extend the September 4th deadline by several months. Additionally, TBR and UT system officials and campus human resources staff must do more to ensure the delivery of education and assistance to all affected higher education employees. This additional time is absolutely necessary to ensure that all higher education employees have access to proper assistance and educational materials about the audit. It is not feasible to think that these efforts will be successful prior to the start of fall term at college and university campuses across Tennessee.

Go to (link...) to send a message to key decision makers on this issue.

Topics:
michael kaplan's picture

Who is Secova?

Submitted by michael kaplan on Thu, 2009/07/23 - 3:57pm.

The State of Tennessee has hired a private company, Secova, to “audit” dependent insurance coverage for all state employees, including higher education staff and faculty.

"Secova is an HR and Benefits Management Services Company focused on helping employers control and drive down the cost of delivering Human Resources and Employee Benefit services. On an annual basis, Secova processes more than 80 million eligibility records, almost $1 billion in healthcare premiums, and manages over 450 vendor and carrier relationships annually on behalf of its clients."

Board of Directors

Venkat Tadanki
Chief Executive Officer

V. Chandrasekaran
Chief Technology Officer

Rahul Bhasin
Baring Private Equity Partners India (BPEP India)

Akhil Awasthi
BPEP India

S.M. Sundaram
BPEP India

P. Viswanathan

TS Campbell's picture

Not just Campus employees

Submitted by TS Campbell (not verified) on Thu, 2009/07/23 - 3:58pm.

When reading the article about the TN state healthcare issue, I noticed a decided bent regarding the scope of the audit. I can understand as a resident of Knoxville how University faculty may prove very influential members of the community, but this insurance change affects ALL STATE EMPLOYEES! That means that your child's kindergarten teacher is affected, the people at the driver's license renewal stations...This is a ridiculously far reaching audit! I would just hope that the state would have hired people who wouldn't be committing dependant fraud in the first place, but clearly the State doesn't think it has!

michael kaplan's picture

this would be an excellent

Submitted by michael kaplan on Thu, 2009/07/23 - 4:03pm.

this would be an excellent issue to bring before the gubernatorial candidates. it's exactly the kind of process bill moyers was talking about in his journal a few weeks ago.

in a comment several years ago, bill haslam stated that it was the mayor's job to "manage scarcity." it seems that's what this issue is about.

bizgrrl's picture

This is one of the most

Submitted by bizgrrl on Thu, 2009/07/23 - 6:13pm.

This is one of the most ridiculous things I have heard of in a long time. UT does everything in the summer when a majority of the faculty and staff are away. There is no doubt they should extend the deadline.

I am curious, is this a normal practice? Is this a government only type of audit/policy or does this happen with private enterprise as well?

We had no proof of our marriage (no marriage licencse) for the first 7 years of our marriage and had no need for it. We finally got one just in case. I'm not sure we've ever had a need to show proof we were married.

Virgil Proudfoot's picture

And what were Secova's political campaign contributions?

Submitted by Virgil Proudfoot on Thu, 2009/07/23 - 6:19pm.

So how much did this foreign company donate to Tennessee politicians in the last few campaign cycles? This might be hard to determine since these were probably disguised through holding companies or other charades, but I'll bet $1.00 that Bredesen and the other criminals in
Nashville got their beaks wet from these guys.

The whole thing is enormously insulting, not to mention yet another way to siphon off taxpayer money to some private company.

Rachel's picture

Remember folks, if health

Submitted by Rachel on Thu, 2009/07/23 - 7:49pm.

Remember folks, if health care reform passes, government bureaucrats will be making your health care decisions!

R. Neal's picture

So, I wonder how much the

Submitted by R. Neal on Thu, 2009/07/23 - 8:21pm.

So, I wonder how much the state is paying these consultants? Will it be more than whatever savings will be realized from whatever abuse is uncovered?

Or worse, are they getting paid based on the amount of "fraud" they "uncover?"

michael kaplan's picture

these contracts are probably

Submitted by michael kaplan on Thu, 2009/07/23 - 8:37pm.

these contracts are probably given out on a bid basis, similar to those for the redlight cameras, with some division of profits/savings between the state and the contractor. it would be interesting to know the details ...

Mello's picture

Link... 3. How did the state

Submitted by Mello on Thu, 2009/07/23 - 8:41pm.

(link...)

3. How did the state select Secova?
Following standard State of Tennessee procurement guidelines and rules, the Department of Finance and Administration, Division of Benefits Administration issued a request for proposals (RFP) to over 15 organizations nationwide with the experience and ability to actively manage our dependent eligibility verification process successfully. Two proposals met the state’s
requirements and were scored. An evaluation team worked independently of each other to score each proposal on the basis of qualifications, experience, and technical approach. The contract was awarded to Secova on the basis of their combined qualifications, technical approach and cost.

michael kaplan's picture

here's part of the answer

Submitted by michael kaplan on Thu, 2009/07/23 - 8:45pm.

from the state of tennessee website:

"Following standard State of Tennessee procurement guidelines and rules, the Department of Finance and Administration, Division of Benefits Administration issued a request for proposals (RFP) to over 15 organizations nationwide with the experience and ability to actively manage our dependent eligibility verification process successfully. Two proposals met the state’s requirements and were scored. An evaluation team worked independently of each other to score each proposal on the basis of qualifications, experience, and technical approach. The contract was awarded to Secova on the basis of their combined qualifications, technical approach and cost."

i'd like to read the contract to see what and cost means.

michael kaplan's picture

the eligibility clause

Submitted by michael kaplan on Thu, 2009/07/23 - 9:01pm.

19. Which dependents are not eligible?

Children who are married
Foster children
Dependents not listed on the enclosed Definitions and Required Documents
Parents or spouse’s parents
Dependent children in the armed services on a full-time basis
Ex-spouses even if court ordered
Live in companions who are not legally married to the employee

Virgil Proudfoot's picture

Still no answer on those political contributions

Submitted by Virgil Proudfoot on Thu, 2009/07/23 - 10:43pm.

Lawmakers can make up any contract they want to; they make the law, so they can decide how contracts are worded and how the rules apply to them. Hey, they make the rules.

The question remains: How much did Secova, or the company that owns it, or the families of its employees, contribute to the campaigns of Bredesen and the other Nashville critters in order to come up with this scheme to shovel the taxpayers' money into its coffers?

And let's face it, folks: Tennesseans, including state workers, are not the most legal-paper-collecting people in the world. How many state employees might somehow miss or mess up on this campaign and end up, through lack of care or due diligence, losing family members' health insurance? That could be a death sentence because, if a policy lapses, then every illness of that family member becomes a pre-existing condition and therefore uncovered by any new policy.

But then, one government policy Tennesseans like is having the state kill Tennesseans.

michael kaplan's picture

i'd look at the redlight

Submitted by michael kaplan on Sat, 2009/07/25 - 8:10am.

i'd look at the redlight contract as a model for the healthcare management contract. i'd suspect secova gets to keep every $75 fine - or at least $50 of each $75 fine - and the state pays secova nothing for its services.

politicians love what they call win/win contracts. it makes them look like they're protecting taxpayers.

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