New York City Office of Labor Relations

Health Benefits Program: Monitoring Dependent Eligibility and Selected Financial Practices

The New York City Office of Labor Relations administers health insurance programs for City government employees and their dependents. The largest such program is the Group Health Incorporated Comprehensive Benefits Program (GHI), which provided services costing about $370 million in the 1995 fiscal year. We examined certain aspects of the Office's payment of GHI premiums as well as the practices for ensuring that dependents receiving health insurance benefits are eligible to receive the benefits. We found that improvements can be made to prevent large premium overpayments, ensure that interest is properly credited when premium overpayments are refunded, and provide better assurance that the amount of premiums reported as paid by GHI were actually paid. We also found that the eligibility of some dependents receiving health insurance benefits was not documented. We recommend that this eligibility be documented by City agencies, and the agencies' efforts be monitored by the Office.

For a complete copy of Report 96-N-9 click here.