Department of Management Services

Dependent Eligibility Verification

During the 2017 Legislative Session, the Florida Legislature directed the Department of Management Services to contract for dependent eligibility verification services for the State Group Insurance Program. A third-party vendor will administer the dependent eligibility verification services in the form of an audit to occur between December 1, 2017 and May 31, 2018. 

The Division of State Group Insurance (DSGI) is contracting with the independent audit firm, HMS, to verify that dependents enrolled in the State of Florida group health insurance plan meet eligibility guidelines to participate in the State Group Insurance Program. (s. 110.12301, F.S.) The audit will be broken into three phases with the first phase beginning on December 29, 2017. To ensure that your dependent(s) will continue to receive benefits under the State of Florida group health insurance plan, you must respond to any requests for documentation to verify the eligibility of your dependent(s). 

 

The table below shows which phase your agency will be audited.

Phase I

December 29, 2017 - March 5, 2018

Phase II

January 26, 2018 - April 3, 2018

Phase III

March 26, 2018 – May 31, 2018

Department of Corrections Department of Children and Families Universities
Department of Health Justice Administration Florida Legislature
Department of Transportation Benefits Only Executive Office of the Governor
Agency for Healthcare Administration Department of Elder Affairs Florida Board of Bar Examiners
Agency for Persons with Disabilities Department of Financial Services Florida Commission on Offender Review
Department of Management Services Department of Highway Safety and Motor Vehicles Florida Department of Law Enforcement
Agency for State Technology Department of Juvenile Justice Florida Fish and Wildlife Conservation Commission
Central Florida Expressway Authority Department of Legal Affairs Florida Inland Navigation District
Department of Agriculture and Consumer Services Department of Military Affairs Miami-Dade Expressway Authority
Department of Business and Professional Regulation Department of Revenue State Courts
Department of Citrus Department of State Tri-Rail
Department of Economic Opportunity Department of the Lottery Volunteer Florida
Department of Education Department of Veterans Affairs West Coast Inland Navigation District
Department of Environmental Protection Division of Administrative Hearings  
  Florida School for the Deaf and Blind  
  Public Service Commission  
  State Board of Administration  

  

Definition of an Eligible Dependent

As a reminder, postcards were mailed to all subscribers in August 2017 detailing the definitions of an eligible dependent. An eligible dependent is defined as:

Your spouse — The person to whom you are legally married.

Your child — Your biological child, child with a qualified medical support order, legally adopted child, or child placed in the home for the purpose of adoption in accordance with applicable state and federal laws through the end of the calendar year in which he/she turns age 26.

Your stepchild — The child of your spouse for as long as you remain legally married to the child’s parent through the end of the calendar year in which he/she turns age 26.

Your foster child — A child that has been placed in your home by the Department of Children and Families Foster Care Program or the foster care program of a licensed private agency through the end of the calendar year in which he/she turns age 26.

Legal guardianship — A child for whom you have legal guardianship in accordance with an Order of Guardianship pursuant to applicable state or federal laws or a child for whom you are granted court-ordered temporary or other custody through the end of the calendar year in which he/she turns age 26.

Your over-age dependent — After the end of the calendar year in which he/she turns 26 through the end of the calendar year in which he/she turns 30 – if he/she is unmarried, has no dependents of his/her own, is a resident of Florida or a full- or part-time student, and has no other health insurance.

Your over-age dependent with a disability — Your covered child with intellectual or physical disabilities. This child may continue health insurance coverage after reaching age 26 and while remaining continuously covered in a State Group Insurance health plan, or the child was over the age of 26 at the time of your initial enrollment. The child must be incapable of self-sustaining employment because of the intellectual or physical disability, and be chiefly dependent on you for care, financial support, and maintenance.

Newborn child of a covered dependent — A newborn dependent of a covered dependent – a newborn child born to a dependent while the dependent is covered under the Plan. The newborn must have been added within 60 days of the birth. Coverage may remain in effect for up to 18 months of age as long as the newborn’s parent remains covered.

Children of law enforcement, probation, or correctional officers — Children of law enforcement, probation, or correctional officers who were killed in the line of duty and who are attending a college or university beyond their 18th birthday.

Surviving spouse and dependents — The widow or widower of a deceased state officer, state employee, or retiree if the spouse was covered as a dependent at the time of death; or an employee or retiree who died before July 1, 1979; or a retiree who retired before January 1, 1976, under any state retirement system who is not eligible for any Social Security benefits. Upon remarriage, the widow or widower is no longer considered a surviving spouse. A surviving spouse shall report remarriage within 60 days of the remarriage. The surviving spouse and dependents, including any eligible children of a surviving spouse, if any, must have been covered at the time of the enrollee’s death and the coverage must have been continuous.

         

REQUIRED DOCUMENTS

All required documents MUST contain the date (including year), employee’s name, and dependent's name. Personal information such as income information listed on the tax transcript and social security information (except in the case of a disabled child or a spouse if you filed as Married Filing Separate) may be marked out for confidentiality purposes.

Please include a copy of the Verification Form signed and dated with all documentation submitted.

    

FOR SPOUSE:

  • If married less than 12 months and you and your spouse have not filed a joint federal income tax return, a government-issued marriage certificate, OR
  • If you and your spouse have been married for 12 or more months, a Tax Return Transcript of your most recently filed (2016 or 2017) federal income tax return showing you filed as married, either jointly or separately. The tax return transcript is the only official record of the tax return that you filed with the IRS.  A copy of your tax return (Form 1040) will not be sufficient.  You can request a copy of your transcript from the IRS at www.irs.gov/individuals/get-transcript or by calling the IRS at 1-800-908-9946.   Please submit ONLY the first page, showing yours and your spouse’s names or the last four digits of their social security number and tax filing period.  All other information should be redacted.  If you are unable to obtain your transcript, please contact HMS.

    

FOR CHILDREN UP TO AGE 26:

  • A copy of the child’s government-issued birth certificate or adoption certificate naming you or your spouse as the child's parent. Please note the document must list the first and last name of the child and parent(s); OR
  • A copy of the court order naming you or your spouse as the child’s legal guardian or custodian.
  • For foster child: A copy of the records showing you or your spouse as the child's legal guardian or custodian.
  • For a newborn child of a Covered Dependent up to age 18 months: A copy of the newborn's government-issues birth certificate listing your covered dependent as the birth parent.

 

FOR UNMARRIED CHILDREN AGE 26 UP TO AGE 30:

  • A copy of the child’s government-issued birth certificate or adoption certificate naming you or your spouse as the child's parent. Please note the document must list the first and last name of the child and parent(s); OR a copy of the court order naming you or your spouse as the child’s legal guardian or custodian; AND
  • A copy of the Affidavit of Adult Child, AND
  • One of the following documents
    • If the child is not a resident of Florida, a document confirming the child’s enrollment in the Spring 2018 semester. The document must include the name of the child, the name of the school, and the school term.
    • A bill or statement in the child’s name that is dated within the past 60 days and is mailed to the child at a Florida address.

         

FOR DISABLED CHILDREN:

  • A copy of the child’s government-issued birth certificate or adoption certificate naming you or your spouse as the child's parent. Please note the document must list the first and last name of the child and parent(s); OR a copy of the court order naming you or your spouse as the child’s legal guardian or custodian, AND
  • A copy of your 2016 Federal Tax Transcript listing the dependent as your tax dependent      

*Note for a stepchild: If you are covering a stepchild you must also provide documentation of your current relationship to your spouse as requested above.

              

Questions? Read our Frequently Asked Questions (Adobe PDF Document 173.34 KB)

Need help with the HMS portal? Read the Verify OS DEVA Participant Guide (Adobe PDF Document 1.15 MB)

Questions about the security of your information? Read the Florida DEVA Security Summary (Adobe PDF Document 74.80 KB)

To contact HMS in reference to the audit, please refer to the contact information below.

  • HMS call center: (877) 577-4549
  • HMS fax number: (877) 223-8478
  • HMS web portal address:  www.verifyOS.com