ULSTER COUNTY

OFFICE OF THE COMPTROLLER

Po Box 1800
Kingston, New York 12402
Telephone: (845) 331-8774 Fax: (845) 340-3697

Elliott Auerbach
Comptroller


Joseph Eriole, Esq.
Deputy Comptroller



July 22, 2014

Sheree Cross, Personnel Officer
244 Fair Street
P.O. Box 1800
Kingston, NY 12402-1800

Re: Health Care Benefits Audit

Dear Ms. Cross:

We are in receipt of your letter of July 17, 2014. Thank you for the correspondence. I would like
to meet with you to discuss it.

We do not understand the import of the categorization you set forth as to the nature of the
individuals on the non-compliant list. From the perspective of health care coverage, the
categorization makes no difference in determining the appropriate course of action for
Personnel. Any non-employee individual who cannot or will not verify their eligibility for
coverage should be subject to the same course of action by your department, and we have
made recommendations as to what that course of action should be. The nature of the
employees supervision or collective bargaining unit has no bearing on whether their
dependents eligibility can be verified or whether the County should continue paying for the
policies of persons who fail or refuse to verify their eligibility. In our meeting we can discuss the
purpose of your letter in this regard, to avoid any misunderstanding.

In addition, we are pleased to learn that the third party administrator Rose & Kiernan (R&K) has
compliance procedures in place to address the issues at hand, except that, (i) our audit did
not disclose the existence, or at least Personnels reliance upon, any such procedures other
than R&Ks notification that a dependent was turning 26, so we would like to know what those
procedures are, and, (ii) it is not clear, based on your letter, what you perceive the issues at
hand to be, so we cannot assess whether this response is meaningful. We would ask that this
be discussed at our meeting, as well, and that R&K be at the meeting or conferenced in by
phone.

We also note that even if such compliance procedures are adopted going forward, those
procedures do not necessarily address the issue of failed verification in the context of our audit.
It is important for us to understand what compliance documentation has been required of
enrollees by the administrator to date, if any, and what, if anything, is proposed to be required
going forward, in order to assess whether it is meaningful in terms of our audit or the
recommendations therein.

Your offer to act immediately should it be determined that any employee took benefits to
which they were not entitled is appreciated, and it recognizes, appropriately in our view, a
duty on your part to respond in such cases. But we point out that at this time you have
knowledge of employees whose dependents eligibility cannot be verified. That fact means that
anywhere from 0 100% of them may have dependents who are taking benefits to which they
are not entitled. The same duty which you have acknowledged makes it necessary for you to
follow up where the enrollee is known to be ineligible, also extends your authority and
obligation to follow up where it is known that they have not verified their eligibility. We reject
any notion that your obligation in that regard is triggered by our Office determining
ineligibility, or that your obligations are in any way limited by whether or not we do so.

Please advise when you can be available to discuss this further.

Very truly yours,

OFFICE OF THE ULSTER COUNTY COMPTROLLER



Joseph P. Eriole, Esq., Deputy Comptroller