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Jim Kenyon: Dartmouth-Hitchcock demands workers’ private papers in insurance audit

  • Jim Kenyon. Copyright (c) Valley News. May not be reprinted or used online without permission. Send requests to

Valley News Columnist
Published: 1/25/2020 10:38:52 PM
Modified: 1/25/2020 10:38:39 PM

Who says Dartmouth-Hitchcock doesn’t care about the well-being of its employees? Just last month, the mega health care organization showered workers with free umbrellas. (Never underestimate the health benefits of staying dry during the cold and flu season.)

Free umbrellas aside, upper management’s efforts to promote D-H as a warm and fuzzy place to work doesn’t hold water.

Not when D-H sends out “internal communications” like the one emailed on Jan. 17 to its employees at Dartmouth-Hitchcock Medical Center, Alice Peck Day Memorial Hospital and Cheshire Medical Center in Keene. (D-H wouldn’t tell me whether the email was sent to employees at its other hospitals as well.)

The email reminded workers that they had until Monday to turn over private documents (marriage certificates, children’s birth certificates and tax returns) or risk losing health care coverage for their dependents.

According to the email, nearly 700 employees had yet to comply with D-H’s directive issued in November.

What’s this about?

Like many businesses (at a place where executives make $500,000 or more annually, I consider D-H a nonprofit in name only), D-H wants to lower its health care costs. Insuring fewer people is one way.

To help with paring its insurance rolls, D-H has hired a Colorado company, Consova Corp., to conduct a “dependent audit.”

According to its website’s sales pitch, Consova can “reduce your total health care spending by 3-5%.” The company’s listed clients include Hertz, Hyundai and Humana.

In November, D-H notified employees that they must send personal documents electronically or by mail to Consova to prove the dependents listed on their medical plan were legitimate.

For many workers, that meant digging through home files to unearth documents that date back decades. Married employees are also required to hand over parts of their 2018 federal tax returns to show they’re still the spouses of the people listed on their marriage certificates.

I recently talked with a D-H physician who had her marriage certificate kicked back by Consova.

The problem? The certificate didn’t include her spouse’s full name. It took a few phone calls, but the doctor finally convinced Consova that the name on the marriage certificate and the name in D-H employment files belong to the same person.

“We had the resources and resolve to fix it,” she told me.

But she worries that some of her patients who work at D-H might not have the “health literacy skills” to navigate the bureaucracy of what D-H is calling the “dependent eligibility verification” process.

“They’re the people who need health insurance the most, and they’re the ones at the greatest risk of being kicked off,” the doctor said. (I’m not using her name because she worries D-H management might hold her speaking out against her.)

In a November letter to employees, D-H wrote that some examples of ineligible dependents include “nieces and nephews living with you who have not been legally adopted or placed in your care under a court order, or grandchildren for whom you may not have been legally designated as primary caregiver.”

Grandkids, really? A health care organization that threatens to take away medical benefits from children — often the most vulnerable segment of our society — to save a few bucks might want to reassess its mission.

But D-H has warned employees that it means business. According to the November letter, “coverage will end for any dependent that either did not meet the eligibility requirements or did not have the required documentation by the deadline.”

In its internal communications, D-H has tried to sell employees on the notion that the audit was required by the IRS to “comply with certain regulations around who is covered under our health plan benefits.”

Apparently, Dartmouth College, which is also a self-insured nonprofit, didn’t get that IRS memo. The college hasn’t conducted a dependent audit and doesn’t have one in the works, Dartmouth officials told me.

Dependent audits have been around for a while. (Consova was founded in 2003.)

Last week, I came across a blog geared toward the human resources industry. In 2014, an international organization called United Benefit Advisors, or UBA, gave employers a bunch of reasons why dependent audits were a bad idea.

“Employee backlash” is a leading reason, Mike Humphrey, a longtime human resources executive, said in an interview posted on the UBA blog.

“One of the biggest issues with the dependent audit is the way employees react,” Humphrey said. “Many employees are, needless to say, offended. They are being asked for documentation to prove that they were married to their wife or that a child is truly theirs.”

I reached Humphrey by phone in Anchorage, Alaska, where he’s the benefits and records manager for Alaska Railroad, a transportation company with more than 600 employees.

Instead of conducting massive dependent audits, employers should consider “gradual fixes,” such as requiring new employees to provide dependent-verifying documentation before they sign up for insurance, Humphrey told me.

In the long run, I’m not sure the audit exercise will lead to big savings for D-H, particularly if dependents who are booted from D-H’s medical plan join the ranks of the uninsured or be shifted to Medicaid as early as March.

The next time those folks get sick, what are the chances they end up in a D-H emergency room with no insurance? Who pays then?

They’ll need more than an umbrella.

Jim Kenyon can be reached at

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