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Benefit Eligibility Requirements (Medical, Dental, and Vision)
You are eligible for medical, dental, and vision coverage if you satisfy one of the following requirements:
- You are a faculty, postdoctoral associate or fellow with an appointment of at least 50% of time
- You are a clerical & technical, service & maintenance, security or YPBA employee scheduled to work at least 20 hours per week
- You are a managerial & professional staff member, police supervisor, or a police command staff member scheduled to work at least 20 hours per week
Various categories of coverage are available for each plan. However, you must enroll yourself to enroll your eligible dependents.
Please note: Visiting faculty are eligible for medical, dental, and vision coverage. Postdoctoral fellows are only eligible for medical and dental coverage.
Eligible Dependents
- Your legal spouse
- Your eligible dependent children
- You and/or your spouse’s natural children, stepchildren, or legally adopted children
- A child placed in your and/or your spouse’s home for legal adoption by you and/or your spouse if the child remains in your and/or your spouse’s home and the adoption procedure have not been terminated, whether or not the adoption has become final
- Your and/or your spouse foster child; or a child for whom you and/or your spouse are the legal guardian
- Disabled dependent children – coverage may be continued past the age of 26 if disability status is met under the Social Security Disability Act
- Faculty and M&P
- Medical/Dental/Vision coverage: Children until end of month in which they reach age 26
- C&T, S&M, Security, and YPBA
- Medical and Vision: Children until end of month in which they reach age 26
- Dental: Children until the end of the month in which they reach age 19 if they are not full-time students. If they are full-time students, then coverage extends until the end of the month that they turn 25
- Faculty and M&P
Dependent Verification
Effective February 1, 2023, individuals who add a new dependent or dependents to their coverage will be required to provide documentation supporting the eligibility of each of those dependents.
Additional information can be found in the Yale University Dependent Verification FAQs.
Changes to enrollment outside of the annual benefits enrollment period can only be completed within 30 days of a qualifying life event.
Please note, false and/or incomplete responses or statements may result in rescission of coverage and/or non-payment of claims for you or your eligible dependents as well as, discipline up to and including possible termination of employment. Understand that your file may be audited at any time to determine the eligibility of yourself and/or any dependent listed on your enrollment for medical and dental coverage.
FAQs
General FAQs
Mercer has been retained by your employer to conduct a Dependent Eligibility Verification on behalf of the University. Mercer has been providing consulting services for more than 65 years, and administrative centers have been providing benefits administration outsourcing services for more than 80 years. They employ approximately 20,000 colleagues with more than 2,000 employees dedicated to benefits administration services.
This process is being conducted to ensure only eligible dependents are provided coverage under the plan. Ineligible dependents enrolled in the plan can increase costs – costs that both you and the University share. It is each employee’s responsibility to ensure covered dependents continually meet the plan’s eligibility requirements and to provide supporting documentation upon request.
When calling the Mercer call center, you must have your Audit ID or employee identification number (EEID) available for identification. Your Audit ID and EEID can be found at the top of the DEV Checklist (page 2) of your notice from Mercer. You will also be asked for additional basic information to verify your identity.
Mercer adheres to strict confidentiality and data security protocols to ensure the security of personal information. The information you provide will be used by Mercer only for the purpose of conducting the Dependent Eligibility Verification process. Once the process is complete, the secure destruction of all paper documentation will be facilitated by Mercer.
The Health Insurance Privacy and Accountability Act of 1996 (HIPAA) contains strict rules about how certain health information must be protected. Mercer employees have completed HIPAA privacy training and undergo background checks prior to employment. Mercer’s operations comply with HIPAA privacy guidelines, and you may obtain a copy of the privacy notice, which is linked to the Helpful Info tab of the Mercer website.
Should you need to make any type of change to the personal information, you must contact Yale Employee Service Center at employee.services@yale.edu or 203-432-5552.
No, the dependent eligibility verification process cannot be used to make changes to your enrollment for eligible dependents. Please contact Yale Employee Service Center at employee.services@yale.edu or 203-432-5552, for information on how to make changes to your benefit elections.
Ineligible dependents are not entitled to COBRA continuation coverage. By definition, COBRA is only available to “qualified beneficiaries”.
There are a couple options that you may pursue.
- Dependent being removed from coverage my consider options with their own employer.
- Dependents being removed from coverage may consider medical insurance options available through the Health Insurance Marketplace. Find additional information by contacting the marketplace helpline at 1-800-318-2596 or by visiting the website.
- Dependents being removed from coverage can purchase private health insurance through the following:
- Directly from the insurance company.
- With the help of an insurance agent or broker.
- From an online health insurance seller.
No, you will not be reimbursed for the time or expense involved in securing and/or submitting the necessary supporting documentation.
Dependents for whom acceptable documentation is not received by the deadline are scheduled to lose their coverage. If you believe that your individual circumstances may prevent you from meeting the required deadline, please contact Mercer immediately to discuss your situation.
Verification FAQs
Yes, if you have been sent the verification packet you are required to respond. Failure to respond or provide sufficient documentation to verify the eligibility of your dependents will result in the removal of your covered dependents.
You may submit your response by secure upload or mail. For the timeliest review of documentation, it is recommended that you submit your material through the DEV website.
Website
Documentation can be securely uploaded by logging into your Workday portal and selecting “View All Apps” from Your Top Apps tile. Then choose the Benefits and Pay Worklet and select the Dependent Verification option from the Benefit Link list.
When uploading your documentation to the website, name the document using letters, numbers, spaces or dots. If you use other characters, your upload will fail.
If responding by mail, a pre-addressed envelope has been provided with your packet.
Upon receipt and review, the status of your response can be confirmed. Standard turn-around time for documentation review is 2-3 business days once the documents arrive at Mercer. For the timeliest review of documentation, it is recommended that you submit your material through the DEV website. If you opt to complete the process through the US mail service it could delay the review of your submission due to time it takes for mail to route to Mercer.
If you submit documents via mail, you must include the DEV Checklist, your Audit ID, or your employer’s name with each submission as Mercer will be unable to connect documentation without this information. If you have already submitted your DEV Checklist but need to make a change, you must submit another and you can visit the DEV Website to obtain a copy of your Checklist. If you have questions, please contact the Mercer Call Center at 855-978-2023.
If one or more dependents do not meet the eligibility, indicate removal by placing an “X” next to the dependent’s name in the “Check To Remove From Coverage” column on the DEV Checklist or logon to the DEV website and under the “Your Dependent(s)” tab, select “Click to Remove.”
Employees who are covering ineligible dependent(s) will have their ineligible dependent(s) removed from coverage, on a go forward basis.
Coverage will end as soon as administratively possible.
Previous premiums paid for ineligible dependents will not be refunded; however, premiums will be adjusted on a go forward basis if your coverage level is reduced.
Dependents required to be covered under a Qualified Medical Child Support Order (QMCSO) will not be removed from coverage. Other court ordered dependents are subject to removal from coverage if verification requirements are not met. Employees are encouraged to provide all appropriate supporting documentation to remain compliant with any court order.
Please send only copies of required documentation as we are unable to return originals. If the document is multiple pages or two-sided, ensure you copy all pages and both sides of the document and that the copied document is still legible.
An official certificate of every birth, death, marriage, and divorce should be on file in the locality (state, city or county) where the event occurred. You may also visit the Centers for Disease Control and Prevention’s vital records page or visit VitalChek to request specific documents by state and obtain information on the approximate costs and time of delivery.
A copy of your tax return may be requested from the Internal Revenue Service website or by contacting the Internal Revenue Service at 1-800-829-1040.
Birth certificates must include the child’s name and must list the name of the employee or employee’s spouse as a parent of the child. The birth record or “short form” will not be accepted for the verification process because this document does not list the name of the mother or father.
All marriage certificates must be presently valid and include the date of marriage. Additionally, legal marriage certificates must show the marriage has been recorded by the appropriate county or state agency.
If your document is in a language derived from the Latin alphabet (Spanish, German, French, etc.), send a copy of the original document and Mercer will make every attempt to translate it. If Mercer is unable to translate it, you will be placed in an incomplete status and an official English translation will be required.
Mercer is unable to translate documents printed in languages that do not use the Latin alphabet, such as those used in Russian, Chinese, Japanese, etc. To assist the process in translating character-based documents, please include a copy of the original foreign language document and an official English translation.
You should submit a copy of your current or previous filed Federal income tax form 1040, 1040A or 1040X (or 1040EZ for spouse only) or your current or previous State income tax form showing your filing status and listing your dependents. To support your spousal relationship, you may submit a copy of your filed 1040 EZ or official transcript of your tax return. Form 8879 (e-form first page) is NOT acceptable.
The entire tax return is not required, only the page that lists filing status and exemptions. The information regarding your marital status, the name of your spouse, and the name(s) of your dependents is required if applicable. Form 887-9 (e-form first page) is NOT acceptable.
Please block out personal financial data and social security numbers on your tax form prior to submission.
You can confirm receipt of your documents as well as monitor the verification progress and dependent status by visiting the DEV website.
The current status of your response is subject to a quality assurance process. During the review of your response, if additional documentation is required you will be contacted by mail. Upon completion of the process you will receive written notification if no further action is required.
Once the verification process is complete, any documentation received by Mercer after the deadline date will not be audited and will be securely destroyed by Mercer.
Website
Your Audit ID is located on the DEV Checklist (page 2) of your notice from Mercer.
To upload your response electronically, please scan your DEV Checklist and copies of the supporting documents for each eligible dependent. Please note the following requirements when trying to upload files:
- the file must be less than 10MB in size
- the file must be one of the following allowable file formats: .PDF, .JPEG, .JPG, .GIF, .PNG, .TIF, .TIFF or .BMP
- name the document using letters, numbers, spaces or dots. If you use other characters, your upload will fail
- the file must not be password protected
- document upload requires latest version of one of the following: Edge, Chrome, Firefox, Opera or Safari
The Live Chat can be used to assist with frequently asked questions. If the ChatBot is unable to answer their question, the participant is redirected to chat with a live agent during Call Center hours of operation. If the participant needs further assistance, the participant will then be instructed to contact our Call Center where they can speak to a live Benefit Counselor.
Yes, data transmitted to and received from the website is encrypted using 256 bit SSL encryption.