Now that everyone knows that almost 10,000 ineligible people have been covered by the state Public Employees Insurance Agency, PEIA cannot move quickly enough to drop them.
CHARLESTON, W.Va. -- Now that everyone knows that almost 10,000 ineligible people have been covered by the state Public Employees Insurance Agency, PEIA cannot move quickly enough to drop them.
PEIA estimates that the state and legitimate rate payers have spent at least $5 million a year on care for spouses and children of public and school employees who were not actually eligible to be enrolled. In some cases, people neglected to inform PEIA of divorces or when children grew too old to be eligible, an audit has found. The ineligible people include 6,506 who were receiving health coverage and 3,258 who where on life insurance plans.
That's almost one in 10 of the 10,000 dependents enrolled in PEIA. While PEIA board members were told 10 percent of dependents are typically found to be ineligible, it was still a surprise, both to the board and to the public.
There were 1,315 people improperly listed as spouses and 5,189 children improperly counted as dependents, including 2,046 children ages 21 to 25.
It is easy to understand the motivation to "forget" to update such records and hope no one notices. Health insurance is expensive and difficult to get outside of a job or family. In addition to its value to guard against financial ruin in the case of serious accident or illness, health insurance has increasingly become a ticket just to get through the door for the most routine health care.
The state and the nation have certainly struggled for years to figure out how to provide health insurance -- and thus access -- to all the in-between groups of people who need it. Young adults just starting out and or ex-spouses often fall into that category. A separate audit of retired public and school employees is not yet finished.
To encourage cooperation and compliance with the audit, PEIA agreed not to penalize insurees who reported ineligible dependents. The insurance agency has sent termination of coverage notices to those who should not have been enrolled.
The quicker PEIA can report to the public how many ineligible people have been removed and the savings to the program, the better.
CHARLESTON, W.Va. -- Now that everyone knows that almost 10,000 ineligible people have been covered by the state Public Employees Insurance Agency, PEIA cannot move quickly enough to drop them.
PEIA estimates that the state and legitimate rate payers have spent at least $5 million a year on care for spouses and children of public and school employees who were not actually eligible to be enrolled. In some cases, people neglected to inform PEIA of divorces or when children grew too old to be eligible, an audit has found. The ineligible people include 6,506 who were receiving health coverage and 3,258 who where on life insurance plans.
That's almost one in 10 of the 10,000 dependents enrolled in PEIA. While PEIA board members were told 10 percent of dependents are typically found to be ineligible, it was still a surprise, both to the board and to the public.
There were 1,315 people improperly listed as spouses and 5,189 children improperly counted as dependents, including 2,046 children ages 21 to 25.
It is easy to understand the motivation to "forget" to update such records and hope no one notices. Health insurance is expensive and difficult to get outside of a job or family. In addition to its value to guard against financial ruin in the case of serious accident or illness, health insurance has increasingly become a ticket just to get through the door for the most routine health care.
The state and the nation have certainly struggled for years to figure out how to provide health insurance -- and thus access -- to all the in-between groups of people who need it. Young adults just starting out and or ex-spouses often fall into that category. A separate audit of retired public and school employees is not yet finished.
To encourage cooperation and compliance with the audit, PEIA agreed not to penalize insurees who reported ineligible dependents. The insurance agency has sent termination of coverage notices to those who should not have been enrolled.
The quicker PEIA can report to the public how many ineligible people have been removed and the savings to the program, the better.
