Anthelio Healthcare Solutions, Inc Sample Initial Letter.pdf - ConSova

Month Day, YearSample – Dependent VerificationIntroductory LetterJohn Smith123 ABC WayAnywhere, USA 99999- IMMEDIATE ACTION IS REQUIRED -IF YOU DO NOT RESPOND TO THE ENCLOSED VERIFICATION REQUEST, BENEFITCOVERAGE FOR YOUR DEPENDENT(S) WILL BE CANCELLED.Dear John Smith:We are proud to offer our employees a comprehensive health plan including medical, dental,and vision coverage. To keep your premiums as low as possible, we want to ensure thatonly eligible dependents are enrolled in the company sponsored programs. Therefore,Anthelio has partnered with ConSova, a benefits audit firm, to complete routine dependenteligibility verifications on our behalf.If you have one or more dependent(s) enrolled in the medical, dental, or vision plan throughAnthelio, you will need to submit supporting documentation to verify their eligibility. Theattached verification request from ConSova provides you with: a list of the dependents you currently have enrolled in an Anthelio-sponsored benefitplan the plan eligibility requirements as set forth in the Summary Plan Description (SPD)Please be assured the information you provide is kept secure and confidential. ConSova, anamed Business Associate of Anthelio as defined under the Health Insurance Portability andAccountability Act of 1996 (HIPAA), complies with all provisions of the law.Please note: This is not a passive verification process. Non-response or incompletedocumentation will result in the termination of insurance coverage for your dependents.Thank you for your cooperation.Sincerely,Misty Lewis, Benefits ManagerCaution: Form contains personalized encoded information. Do not share with others.

Frequently Asked QuestionsWho is ConSova?ConSova is a Human Resources firm that specializes in the dependent eligibility verificationprocess and has conducted many dependent audits for Fortune 500 companies andgovernmental organizations.What guarantee do we have that our personal documents will be kept secure?ConSova considers security and confidentiality a very serious matter. They utilize encryptiontechnology to transact sensitive data. The server that maintains Dependent EligibilityVerification data is only accessible on ConSova’s closed network located in Lakewood, COand at a SOC 2 Type II, SOC 3 compliant secure data center located in Englewood,Colorado. This network is a closed system that is only accessible inside the ConSova domainand via a secure Virtual Private Network.ConSova Associates have audited over 1.5 million dependents in the past eight years, andthey have never been accused or alleged to have not protected the private personalinformation of its clients’ employees. Anthelio realizes and understands that employees mayhave concerns about releasing this information to a third party. We assure you that everyprecaution has been taken to ensure your information is kept confidential. This is nodifferent than what our other service providers must prove. You can help protect your ownprivacy by following the instructions included with the letter you will receive from ConSova.Will the submitted documents be retained by ConSova? If so, for how long?Documentation received from Anthelio employees will be batched and maintained in asecure location monitored only by ConSova employees. 30 days after the dependentverification is completed, ConSova will shred all documentation.Can I black out my financial information and Social Security number on thesedocuments?On any document you provide, you may cross out all financial information and the first fivedigits of your Social Security number.Can my local Human Resources Department review my documents to determineeligibility of my dependents instead of ConSova?No. Anthelio will not review any documentation for the verification process. All documentsmust be provided to ConSova for review.If I am unable to supply documentation by the deadline for my eligible dependent,will Anthelio terminate my dependent from the plan?Eventually, Anthelio will terminate a dependent due to the inability to providedocumentation that verifies eligibility. However, if you are in contact with ConSova duringthe verification process and ConSova is aware of an issue you may be experiencing ingathering the appropriate documents, then your dependent will not be automaticallyterminated if you do not meet the deadline. ConSova is willing to assist you through thisprocess, including helping you contact agencies to locate the documents you need.Caution: Form contains personalized encoded information. Do not share with others.

Month Day, YearDear John Smith:Dependent Eligibility VerificationAs part of Anthelio’s initiative to help keep benefit premiums as low as possible, they haveretained ConSova’s services to review and verify eligibility for covered dependents.Dependent(s) you have included on Anthelio sponsored medical, dental and/or vision plans arelisted below:Dependent Name Relationship Year of BirthMichelle Smith Spouse 1956Jane Smith Child 1990Julie Smith Child* 1998Your Action Items Review the dependent information above and the detailed explanation of the documentationyou will need to provide to verify eligibility for dependent(s) on the following pages. If any of your dependents listed above are no longer eligible for medical, dental and/or visioncoverage, please provide their names and the reason for ineligibility on attached IneligibleDependent Form. Coverage for ineligible dependents will end back to the date of enrollment.Upload documentation by logging into https://www.securewebhelp.com, you will need yourPIN number to log in to the website; your PIN number is located at the bottom left handcorner of this letter. Or you may also mail documentation along with a copy of this letter inthe enclosed postage-paid envelope with a postmark on or before Month Day, Year.Please note: This is not a passive verification process. Non-response or incompletedocumentation will result in the termination of insurance coverage for your dependents. Onceyour submitted documentation has been reviewed, ConSova will mail a letter to you regardingthe updated status and if any additional information is required.If you have any questions about this process or need assistance, please call ConSova’sDependent Eligibility Verification Assistance Center at (866) 964-1318 Monday through Friday,9:00 a.m. – 5:00 p.m. Central Time.Would you like to receive ConSova communications electronically? Simply log into ConSova’swebsite at www.consova.com/anthelio and select ConSova’s “Going Green” option at the top ofthe page to learn more about our paperless optionThank you for your cooperation during this important initiative.Sincerely,ConSova CorporationCaution: Form contains personalized encoded information. Do not share with others.

Ineligible Dependent FormIf any of your dependent(s) are no longer eligible for medical, dental and/or visioncoverage, please provide his/her name(s) and the reason for ineligibility below. Or you mayleave a comment on your secure web portal with the dependents name and reason forineligibility by logging into https://www.securewebhelp.com and clicking the “submit comment”tab. You will need your PIN number to log in to the website; your PIN number is located at thebottom left hand corner of this letter.Coverage for ineligible dependents will end back to the date of enrollment.Ineligible Dependent NameIneligibility ReasonSignature of Employee:Date:By signing above, I certify and warrant to Anthelio that all information on this Dependent Verification Form is true,correct and current as of the date signed. I further understand that if I knowingly submit false information I maybe subject to disciplinary action up to and including termination of employment. I authorize Anthelio and ConSovaCorporation to contact any institution or organization to verify any and all documents provided for eligibilityverification.Please mail or upload this completed and signed form along with therequested verification documentation.Caution: Form contains personalized encoded information. Do not share with others.

DependentRelationshipSpouseYour legally marriedspouse(legally separated ordivorced spouses arenot eligible forcoverage)Dependent Documentation RequestWhat You Need to Submit to ConSovaCopy of marriage certificateDocuments RequiredANDA copy of your 2012 tax return (front page through line 6 of Form 1040);please black out the first five digits of your SSN and all financial information.Note: if your spouse files married separately, head of household or single, youwill also need to submit their 2012 Form 1040 (front page through line 6).Please black out any financial information and social security numbers. We onlyneed the last 4 digits of the employee's SSN.Child under age 26• Your natural child,legally adopted child,or child in theprocess of beingadopted;• Stepchild;• Foster child; or• A child who is thesubject of a QualifiedMedical Child SupportOrder (QMCSO)issued to you.A copy of the following documents (varies by the relationship of the child to theEmployee):• Natural child or legally adopted child: State or county issued birthcertificate showing employee’s name or signed court order• Stepchild: State or county issued birth certificate showing parents’ names,copy of your Marriage Certificate, and copy of your joint 2012 federal taxreturn (front page only).• Foster child: Signed letter from social service agent confirming child hasbeen placed under your care and your 2012 federal tax return claiming thechild as a dependent• Child who is the subject of a Qualified Medical Child Support Order:Signed Court Order*No additional documentation required; QMCSO/Court Order on file.If unable to provide any of the documents requested, the employee will need to contact ConSova for alternative documents ifapplicable.Don’t Forget! Your response is required by Month Day, Year.Caution: Form contains personalized encoded information. Do not share with others.