Vendor will perform a Working Spouse Provision Verification (WSPV) to verify member compliance with PEIA’s plan regulations with regard to spousal insurance. The population to be audited is estimated at 13,500 - the vendor will review the entire population, whether higher or lower than this estimated population. 5.1.1. Vendor will use data provided by PEIA to verify that member spouses who are not currently being charged a working spouse surcharge are legitimately exempt from such surcharge. 5.1.2. Vendor must have access to, own or utilize a data system capable of identifying the employment status of a PEIA family policyholder’s spouse. 5.1.3. Vendor must verify and confirm the availability of and/or existence of other available health coverage(s) using proven methodology(ies) including, but not limited to: Using databases and/or third-party sources to verify spousal coverage eligibility Contacting spousal employers for benefit eligibility information Communicating with PEIA policyholders Other - must be clearly defined by the Vendor ...
