UHC/Oxford New York Qualifying Events Audit

UHC/Oxford New York has advised that moving forward, they will be conducting qualifying event audits on a sample of small group members each month. The audits will be to validate the eligibility of the enrollment activity. The first set of notifications were mailed out February 5th, with a response date of April 1st.

  • Notification Letters were sent to the group, member and broker requesting documentation validating the Qualifying Event.
  • Notification Letters will be going out each month, the response will be due by the 1st of the month following 30 days from the date of the letter.
  • If no response is received or the member cannot provide the required documentation to support the qualifying event by the deadline, their medical coverage will be canceled on the date per the notification.

We will be receiving a list from UHC/Oxford next week indicating small group members that will be under audit April 1st. We will notify you if one of your group members is affected so we can ensure the group is aware to avoid member termination.