Specifications include, but are not limited to: Dependent Eligibility Verification Audit of all spouses and children (hereafter referred to as “dependents”) enrolled in the Health and Dental plans for the State’s active Employees, Retirees and Legislators (both current and former). The overall goal of this project is to avoid future payment of healthcare claims (includes medical, prescription drugs, and dental claims) for ineligible dependents. The Dependent Audit will be organized and conducted in two groups. Both Group 1 and Group 2 should be completed on or before October 31, 2022. The State and the successful bidder will develop and mutually agree upon a schedule of critical dates and milestones. Group 1 There are approximately 3,360 Medicare eligible Retirees with spouse coverage, 801 NonMedicare Retirees with spouse coverage and 39 Legislators with spouse coverage. Group 2 There are approximately 7,100 active Employees with 7,000 Spouses and 9,300 Children. Projected Average Annual Health Benefits Plan & Dental Plan Costs The projected average annual Health Benefits cost for dependents on each plan are as follows: a. Non-Medicare Retiree Health Benefit plan: $12,839.00. b. Medicare eligible Retiree Health Benefit plan: $5,166.00.
