In May, UC HR/Benefits will conduct its annual random audit of family members enrolled in UC-sponsored health and welfare plans.

Randomly selected employees and retirees will receive a letter asking them to submit documentation to verify that their family members are eligible for health and welfare benefits under UC's rules.

This yearly audit helps ensure that those enrolled in UC health and welfare plans are fully eligible for coverage. The audit also ensures premium and claim costs are incurred only for eligible family members.

The consequence for an employee enrolling an ineligible individual is the permanent de-enrollment (cancellation of coverage) of the ineligible individual. In addition, the employee and all family members will be de-enrolled for 12 months. Failure to respond to the University's eligibility verification letter or failure to provide the required documentation when requested will also result in de-enrollment of you and your family members. For example, if the audit process determines that an ineligible individual is enrolled in a UC-sponsored medical plan, such as Health Net, the employee and all other family members will be de-enrolled for 12 months. The ineligible family member(s) will be permanently de-enrolled.

Review Eligibility of Enrolled Family Members

Each year, the audit results in de-enrollment of a number of UC employees, retirees, and their family members. Employees are asked to review their health and welfare plan enrollments immediately to ensure all enrolled family members are eligible under UC's rules. You can access your enrolled family member information through the At Your Service website. Please insure that address changes are recorded correctly with your Benefits and Payroll Offices. You can also make changes online, at the At Your Service website or contact the person in your department who handles benefits.

If you have ineligible family members enrolled, such as a child who recently married or an ex-spouse you forgot to de-enroll, complete an Enrollment, Change, Cancellation, or Opt Out form (UPAY 850) and submit the form to your local Benefits Office as soon as possible. This form is also available from your local Benefits Office. Changes made once an audit begins are subject to the penalties of the audit.

If you are de-enrolled, you may be able to continue coverage at your expense. UC will not make any contributions for the insurance coverage during the continuation period.

For additional information on eligibility, refer to UC's Group Insurance Eligibility Factsheet, available on At Your Service. If you have any additional questions about the audit, please contact your local Benefits Office.