Humana to Conduct Eligibility Vertifications in Commercial Population

Starting August 4, 2021, Humana will begin conducting eligibility verifications of spouse, common law spouse, or domestic partner dependents in its commercial population through an independent vendor. Please be aware that employees of one or more of your groups may be asked to validate dependent information. On average, approximately 8.1 percent of spousal and domestic partner dependents are found to be ineligible for coverage, according to the vendor’s research.

Self-funded and federal employer groups will be exempt from this process. If a dependent is determined to be ineligible, coverage will terminate in compliance with applicable state regulations. Humana will not seek to recover paid claims, so there is no financial impact to the ineligible dependent.

Notification of this process will be sent to employer groups starting July 22, 2021. You can view a sample of the group communication by clicking here. Outreach to employees will begin on August 4, 2021. Dependents will be able to verify eligibility through a variety of methods. They will have a 45-day time period to respond to the verification inquiry.

Contact your Cornerstone representative with any questions!