Safran USA, Inc. Sample Initial Letter.pdf - ConSova

Month Day, YearDear John Smith:Dependent Eligibility VerificationAs part of Safran USA’s initiative to control benefit costs, they have retained ConSova’s services toreview and verify eligibility for covered dependents.Dependent(s) you have included on Safran USA, Inc. sponsored medical and dental plans are listedbelow:Dependent Name Relationship Year of BirthMichelle Smith Spouse 1956Jane Smith Child 1990Your Action Items Review your list of dependents above and the detailed explanation of the documentation you will needto provide to verify eligibility for dependent(s) on the following pages.If any of your dependents listed above are no longer eligible for medical or dental coverage, pleaseprovide their names and the reason for ineligibility on attached Ineligible Dependent Form. Coveragefor ineligible dependents will end as soon as administratively possible.Upload documentation by logging into https://www.securewebhelp.com, you will need your PINnumber to log in to the website; your PIN number is located at the bottom left hand corner of thisletter. Or you may also mail documentation along with a copy of this letter in the enclosed postagepaidenvelope with a postmark on or before Month Day, Year.Please note: This is not a passive verification process. Non-response or incomplete documentation willresult in the termination of insurance coverage for your dependents. Once your submitted documentationhas been reviewed, ConSova will mail a letter to you regarding the updated status and if any additionalinformation is required.If you have any questions about this process or need assistance, please call ConSova’s DependentEligibility Verification Assistance Center at (855) 261-6215 Monday through Friday, 9:00 a.m. – 5:00p.m. Central Time.ConSova’s Privacy Policy can be found on our corporate website athttp://www.consova.com/privacy-policy.php.Would you like to receive ConSova communications electronically? Simply log into ConSova’s website atwww.consova.com/safran and select ConSova’s “Going Green” option at the top of the page to learn moreabout our paperless option.Thank you for your cooperation during this important initiative.Sincerely,ConSova CorporationCaution: Form contains personalized encoded information. Do not share with others.