DEVA Pre-Audit FAQs

NYC Health Benefits Program

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1. Why is the NYC Health Benefits Program conducting a Dependent Eligibility Verification?

   The NYC Health Benefits Program provides health coverage for members and eligible family members (dependents). The Dependent Eligibility Verification process is being used to confirm the continuing eligibility of your dependents.

   
   

2. Who is HMS?

   Health Management Systems, Inc. (HMS) is an independent firm with whom NYC has partnered to verify that all dependents enrolled in the NYC Health Benefits program meet the City’s eligibility guidelines for City health insurance coverage. HMS specializes in verifying health plan eligibility and has reviewed verification documentation for millions of dependents for some of the largest employers in the United States.

   
   

3. What if I do not receive a Dependent Eligibility Verification notice when others do?

   Notices will be sent in batches, not everyone will receive a notice at the same time.

   
   

4. The documentation required contains sensitive information. Is this process secure?

   Protecting personal information is a priority to NYC and HMS. In compliance with applicable U.S. (federal) and state regulations, information and documentation submitted to HMS for the Dependent Eligibility Verification program is stored, processed, and protected by physical, electronic, and procedural safeguards. When submitting your tax documentation, only the top portion which includes the names of the employee/retiree, spouse, and any dependent child(ren) is required. Please mark out Social Security Numbers, as well as any income information.

   All physical, inbound mail is securely stored for the duration of the Dependent Eligibility Verification Process. After 60 days after the completion of the Dependent Eligibility Verification, all inbound email will be shredded and destroyed. Electronic copies of documents submitted to HMS will be securely stored within the HMS system for the duration of the Dependent Eligibility Verification Process. 60 days after the completion of the Dependent Eligibility Verification, all electronic copies will be securely purged and destroyed. Please note that documents submitted to HMS will NOT be returned.

   
   

5. Do I need to send original documents?

   Please do not send your original documents as they will not be returned; a copy is sufficient. If the document is two-sided or has multiple pages, ensure you copy all pages and both sides of the paper.

   
   

6. If I have already verified my dependents with the New York City Health Benefits Program since 2023, will I have to do it again?

   No, if you verified your dependents between 2023 and 2026 with the New York City Health Benefits program, then you will not have to verify your dependents again, and you should not receive any communication from HMS.

   
   

7. May I provide my dependent eligibility documents to my Human Resources Department?

   No. HMS is an independent third-party company with whom NYC has contracted to verify the eligibility of dependents covered under its health benefit plans. Therefore, all documentation must be submitted directly to HMS. The only way to ensure that all documents are logged appropriately and eligibility of your dependents is verified is to submit your supporting documentation to HMS during your verification cycle. If you have questions at that time, you should call HMS at the phone number provided in the letter that will be sent to you from HMS.

   
   

8. How will I know if my information has been accepted and my dependents are verified?

   Once your documentation has been received by HMS, you may check the status of each of your dependents by logging into the HMS website. In addition, you will receive written communication indicating either that you have completed the dependent verification process or if additional information is needed.

   
   

9. What types of documents will I need to submit to HMS to verify my dependents?

   Typical documents for your spouse/domestic partner include a copy of your government-issued marriage certificate or certificate of domestic partnership and a secondary document to prove current relationship status. This secondary document could be a recent joint tax return, joint utility bill, or joint statement of account. All account numbers, SSN, and financial information can be redacted/blacked out before submitting the documents to HMS.

   For children, typical documents include a copy of the child’s birth certificate, adoption decree, or Court documentation showing legal guardianship was granted to you or your spouse/partner.

   The HMS letter will outline all options to verify your dependent’s eligibility. You may also contact HMS if you need help with selecting documents to submit.

   
   

10. What should I do if I do not have the required documents to verify my dependent(s)?

    We understand that it may be difficult for some employees to obtain the required documentation. Once the verification begins, please contact HMS if you require assistance on how to obtain the required document(s) and discuss document alternatives that may be applicable.

    National Center for Health Statistics

    
    

11. How can I submit my documents to HMS?

    You can submit documents using one of the below methods, however, you must wait until you receive the letter from HMS before you can submit your documents. Your documents will not be accepted if they are sent before you receive the letter from HMS.

• - Mail: a postage paid envelope will be included in the envelope with the letter from HMS
• - Fax: electronic fax line
• - Upload: using a computer, tablet, or mobile device

  
  

12. What happens if I do not submit all required documents by the verification deadline?

    If you do not submit complete documentation for your dependents by the deadline, the affected dependent(s) for whom complete documentation has not been submitted will be removed from your City Health Benefits coverage.

    
    

13. If my dependent is found ineligible, are there options for continuing coverage?

    Yes, if your dependent is no longer eligible, please visit the City’s Health Benefit Program’s website at nyc.gov/hbp under the forms and downloads section for COBRA information and rates. COBRA, or the Consolidated Omnibus Budget Reconciliation Act, offers individuals who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances.

    
    

14. I prefer email communications rather than mailed letters. Can I elect to receive follow up communications about the verification process through email instead?

    Yes. The letter from HMS will contain instructions on how to opt-in to email communications.

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