U.S. OFFICE OF PERSONNEL MANAGEMENT
OFFICE OF THE INSPECTOR GENERAL
OFFICE OF AUDITS
Audit of the Federal Employees Dental and Vision
Insurance Program Operations as Administered
by UnitedHealthcare Insurance Company
for Contract Years 2014 and 2015
Report Number 1J-0B-00-16-063
September 29, 2017
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This report has been distributed to Federal officials who are responsible for the administration of the subject program. This non-public version may
contain confidential and/or proprietary information, including information protected by the Trade Secrets Act, 18 U.S.C. § 1905, and the Privacy Act,
5 U.S.C . § 552a. Therefore, while a redacted version of this report is available under the Freedom of Information Act and made publicly available on
the OIG webpage (http://www.opm.gov/our-inspector-general), this non-public version should not be further released unless authorized by the OIG.
EXECUTIVE SUMMARY
Audit of the Federal Employees Dental and Vision Insurance Program Operations
as Administered by UnitedHealthcare Insurance Company
Report No. 1J-0B-00-16-063 September 29, 2017
Why Did We Conduct the Audit? What Did We Find?
The objective of the audit was to
determine whether costs charged to the
The results of our review showed that the Plan had sufficient
Federal Employees Dental and Vision policies and procedures in place to ensure that it accurately
Insurance Program (FEDVIP) and reported its annual accounting statement to OPM and accurately
services provided to its members for developed its FEDVIP rate proposals for 2014 and 2015.
contract years 2014 and 2015 were in
accordance with Contract Number Additionally, we found that the Plan’s proposed transfer of funds
OPM01-FEDVIP-01AP-13 (Contract) for unreimbursed FEDVIP expenses from contract years 2007 to
and applicable Federal regulations. 2013 was allowable, accurate, and in compliance with the prior
contract.
What Did We Audit?
The Office of the Inspector General has However, the audit determined that the Plan did not coordinate
completed a performance audit of benefits with other Federal Employees Health Benefits Program
UnitedHealthcare Insurance Company’s carriers as is required by the Contract.
(Plan) annual accounting statements,
claims processing, and rate proposals as
they relate to FEDVIP operations for
contract years 2014 and 2015. We also
conducted a limited-scope review to
determine if a transfer of unreimbursed
expenses for FEDVIP operations from
contract years 2007 to 2013 was
correctly calculated and allowable. Our
site visit was conducted from
October 24 through 28, 2016, at the
Plan’s office in Columbia, Maryland.
Additional audit field work was
completed at our offices in Washington,
D.C. and Cranberry Township,
Pennsylvania.
_______________________
Michael R. Esser
Assistant Inspector General
for Audits
i
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ABBREVIATIONS
Act Federal Employee Dental and Vision Benefits Enhancement Act
of 2004
Contract Contract Number OPM01-FEDVIP-01AP-13
EOB Explanation of Benefits
FEDVIP Federal Employees Dental and Vision Insurance Program
FEHB Federal Employees Health Benefits
OIG Office of the Inspector General
OPM U.S. Office of Personnel Management
Plan UnitedHealthcare Insurance Company
ii
This report is non-public and should not be further released unless authorized by the OIG, because it may contain confidential and/or proprietary
information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
IV. MAJOR CONTRIBUTORS TO THIS REPORT
TABLE OF CONTENTS
Page
EXECUTIVE SUMMARY ......................................................................................... i
ABBREVIATIONS ..................................................................................................... ii
I. BACKGROUND ..........................................................................................................1
II. OBJECTIVES, SCOPE, AND METHODOLOGY ..................................................2
III. AUDIT FINDINGS AND RECOMMENDATIONS.................................................6
A. Annual Accounting Statement Review ....................................................................6
B. Claims Processing Review .......................................................................................6
1. Coordination of Benefits....................................................................................6
C. Rate Proposal Review .............................................................................................8
APPENDIX (The Plan’s Response to the Draft Report, dated May 5, 2017)
REPORT FRAUD, WASTE, AND MISMANAGEMENT
IV. MAJOR CONTRIBUTORS
I. BACKGROUND
TO THIS REPORT
This report details the results of our audit of the Federal Employees Dental and Vision Insurance
Program (FEDVIP) operations as administered by UnitedHealthcare Insurance Company (Plan)
for contract years 2014 and 2015. The audit was performed by the U.S. Office of Personnel
Management’s (OPM) Office of the Inspector General (OIG), as authorized by the Inspector
General Act of 1978, as amended.
The FEDVIP was created on December 23, 2004, by the Federal Employee Dental and Vision
Benefits Enhancement Act of 2004 (Act). The Act provided for the establishment of programs
under which supplemental dental and vision benefits are made available to Federal employees,
retirees, and their dependents.
OPM has overall responsibility to maintain the FEDVIP website, act as a liaison and facilitate
the promotion of the FEDVIP through Federal agencies, be responsive on a timely basis to the
carriers’ requests for information and assistance, and perform functions typically associated with
insurance commissions such as the review and approval of rates, forms, and educational
materials.
OPM’s Contracting Office contracts with the Plan to provide vision coverage to Federal
beneficiaries enrolled in the Plan under the FEDVIP. The Plan’s responsibilities under Contract
Number OPM01-FEDVIP-01AP-13 (Contract) are carried out at its offices located in
Columbia, Maryland. Section I.11 of the Contract includes a provision, Inspection of Services –
Fixed Price, which allows for audits of the Plan’s FEDVIP operations.
This was the OIG’s first audit of the Plan’s administration of the FEDVIP. The initial results of
this audit were discussed with Plan officials during an exit conference on March 17, 2017. A
draft report was provided to the Plan on April 10, 2017, for its review and comment. The Plan’s
response to the draft report was considered in preparation of this final report and is included as
an Appendix.
1 Report No. 1J-0B-00-16-063
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information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
IV. OBJECTIVES,
II. MAJOR CONTRIBUTORS
SCOPE, ANDTO THIS REPORT
METHODOLOGY
The main objective of the audit was to determine whether costs charged to the FEDVIP and
services provided to its members for contract years 2014 and 2015 were in accordance with the
terms of the Contract and applicable Federal regulations. Additionally, we conducted a limited-
scope review to determine if a transfer of unreimbursed expenses for FEDVIP operations from
contract years 2007 to 2013 was correctly calculated and allowable.
Our specific audit objectives included:
Annual Accounting Statement Review
To determine if the Plan’s premiums received and vision benefits paid were accurately
reported in the annual accounting statements.
To determine the Plan’s allocation methodology for administrative expenses and verify
that the correct percentage was applied.
To determine if the Plan’s proposed transfer of funds for unreimbursed expenses for
FEDVIP operations from contract years 2007 to 2013 was allowable and in compliance
with the prior contract. Specifically, to determine if the Plan’s calculation of the
proposed transfer of unreimbursed expenses for FEDVIP operations from contract years
2007 to 2013 was accurate and if the transfer should be approved by OPM.
Claims Processing Review
To determine if the Plan paid claims in accordance with the terms of the Contract, its
annual benefit brochures, and its internal policies and procedures.
To determine if the Plan paid any vision claims to debarred providers.
To determine if the Plan properly coordinated vision benefits with other insurance
providers.
Rate Proposal Review
To determine if the Plan accurately developed its FEDVIP premium rates.
Scope and Methodology
We conducted this performance audit in accordance with generally accepted government
auditing standards. Those standards require that we plan and perform the audit to obtain
2 Report No. 1J-0B-00-16-063
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information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
sufficient and appropriate evidence to provide a reasonable basis for our finding and conclusion
based on the audit objectives. We believe that the evidence obtained provides a reasonable basis
for our finding and conclusion based on the audit objectives.
This performance audit included reviews of the Plan’s annual accounting statement, claims
processing, and rate proposals as they relate to FEDVIP operations for contract years 2014 and
2015. Our site visit was conducted at the Plan’s office in Columbia, Maryland, from October 24
through 28, 2016. Additional audit work was completed at our offices in Washington, D.C. and
Cranberry Township, Pennsylvania.
The Plan reported the following premium revenue, claim benefits paid, administrative expenses,
and profit (loss) for contract years 2014 and 2015:
Contract Premium Benefits Administrative
Profit
Year Revenue Paid Expenses
2014 $24,352,400 $16,634,729
2015 $25,352,823 $20,864,392
Total $49,705,223 $37,499,121
In planning and conducting the audit, we obtained an understanding of the Plan’s internal control
structure to help determine the nature, timing, and extent of our auditing procedures. This was
determined to be the most effective approach to select areas of audit. For those areas selected,
we primarily relied on substantive tests of transactions and not tests of controls. Additionally,
since our audit would not necessarily disclose all significant matters in the internal control
structure, we do not express an opinion on the Plan’s system of internal controls taken as a
whole.
We also conducted tests of accounting records and other auditing procedures as we considered
necessary to determine compliance with the Contract and 5 CFR Part 894. Exceptions noted in
the areas reviewed are set forth in the “Audit Findings and Recommendations” section of this
report. With respect to the items not tested, nothing came to our attention that caused us to
believe that the Plan had not complied, in all material respects, with those provisions.
In conducting the audit, we relied to varying degrees on computer-generated data provided by
the Plan. Due to time constraints, we did not verify the reliability of the data generated by the
various information systems involved. However, while utilizing the computer-generated data
during our audit, nothing came to our attention to cause us to doubt its reliability. We believe
that the data was sufficient to achieve our audit objectives.
3 Report No. 1J-0B-00-16-063
This report is non-public and should not be further released unless authorized by the OIG, because it may contain confidential and/or proprietary
information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
To determine whether costs charged to the FEDVIP and services provided to its members for
contract years 2014 and 2015 were in accordance with the terms of the Contract and applicable
Federal regulations, we performed the following audit steps:
Annual Accounting Statement Review
We reconciled the Plan’s premiums received and vision benefits paid to determine if they
were accurately reported in the annual accounting statements.
We met with Plan personnel to determine what allocation methodology was used for
administrative expenses and recalculated the percentages based on direct and indirect
costs to verify that the correct percentage was applied.
We reviewed the prior contract to determine if the Plan’s proposed transfer of funds for
unreimbursed expenses from contract years 2007 through 2013 was allowable and in
compliance with the contractual requirements. Additionally, we reconciled the proposed
transfer amount to vision claims benefits and general and administrative expenses
incurred to operate the FEDVIP from 2007 through 2013 to determine if the Plan’s
calculation is accurate and if the transfer of funds should be approved by OPM.
Claims Processing Review
We selected a random sample of 150 claims paid in 2014 and 2015, totaling $9,841, to
determine if they were properly paid in accordance with the terms of the Contract, the
Plan’s annual benefit brochures, and its internal policies and procedures. Specifically, we
selected:
o 75 claims paid in 2014, totaling $5,445, from a universe of claims paid,
totaling $ ; and
o 75 claims paid in 2015, totaling $4,396, from a universe of claims paid,
1
totaling $ .
We reviewed all vision claims from 2014 and 2015 to determine if any were paid to
providers debarred by the OPM OIG.
We reviewed the Contract and the Plan’s 2015 benefit brochure to determine its
responsibility for coordinating benefits. We also met with Plan personnel to determine its
process for coordinating benefits and reviewed policies and procedures to determine if it
1
2014 and 2015 claims data did not match what the Plan reported in its 2014 and 2015 Annual Accounting
Statements due to the universe of claims data including the gross amount of claims paid (insurance costs) and
adjustments for non-insurance costs while the claims reported in the Annual Accounting Statements included actual
claims paid and lab costs.
4 Report No. 1J-0B-00-16-063
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information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
properly coordinated benefits with other Federal Employees Health Benefits (FEHB)
Program carriers.
Rate Proposal Review
We traced the data used to develop the Plan’s 2014 and 2015 premium rate proposals
back to supporting documentation to determine if the Plan accurately developed its
FEDVIP premium rates.
The samples mentioned above that were selected and reviewed in performing the audit, were not
statistically based. Consequently, the results could not be projected to the universe since it is
unlikely that the results are representative of the universe taken as a whole.
5 Report No. 1J-0B-00-16-063
This report is non-public and should not be further released unless authorized by the OIG, because it may contain confidential and/or proprietary
information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
III. AUDIT FINDINGS AND RECOMMENDATIONS
A. Annual Accounting Statement Review
The results of our review showed that the Plan had sufficient policies and procedures in place to
ensure that premiums received, claims paid, and expenses incurred were properly accounted for and
reported to OPM in accordance with the Contract.
Additionally, we found that the Plan’s proposed transfer of funds for unreimbursed FEDVIP expenses
from contract years 2007 to 2013 was allowable, accurate, and in compliance with the prior contract.
B. Claims Processing Review
1. Coordination of Benefits Procedural
The Plan did not coordinate benefits with FEHB Program carriers in accordance with the
Contract’s requirements.
The Plan did not
Both the Contract [Section C (II)] and the Plan brochure (First Payor) state
coordinate
that the Plan is responsible for facilitating the First Payor process with
benefits with
FEHB Program carriers, which will provide primary benefits.
FEHB Program
carriers.
During our audit, we reviewed the Plan’s universe of claims paid in
2014 and 2015 and found no indication that the Plan coordinated benefits with FEHB Program
carriers. Additionally, the Plan stated that it does not coordinate benefits with FEHB Program
carriers. Instead of coordinating benefits, the Plan updated its provider manual in July 2016, to
require the vision providers to verify the member’s FEHB coverage and bill the FEHB Program
carrier prior to billing the Plan. The Plan also stated that there are no mechanisms in place to
track or determine if the providers are complying with the coordination of benefits requirements
established by the provider manual.
Based on the Plan’s response, it did not have procedures in place during the scope of our audit to
properly ensure that claims were coordinated with FEHB Program carriers. It should be noted
that the Plan’s responsibility for coordinating benefits with FEHB Program carriers dates back to
January 1, 2007 (the inception of the FEDVIP). However, the Plan only updated its provider
manual for coordination with FEHB Program carriers in July of 2016. Therefore, throughout its
first nine-plus years of administering the FEDVIP, there were no controls in place to coordinate
benefits between the Plan and FEHB Program carriers.
6 Report No. 1J-0B-00-16-063
This report is non-public and should not be further released unless authorized by the OIG, because it may contain confidential and/or proprietary
information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
By requiring the providers to coordinate benefits, the Plan is deferring its responsibility to the
provider. As a result of delegating its responsibility, and by not having a means of tracking or
determining if its providers have coordinated benefits, the Plan is not meeting its requirements as
set forth in the Contract. Also, by not monitoring the process, the Plan is inadvertently permitting
an avenue for potential fraud where providers could coordinate with an FEHB Program carrier
and also submit the claim to the Plan for full reimbursement.
Recommendation 1
We recommend that the Plan amend its existing policies and procedures to ensure that it properly
coordinates benefits with those FEHB Program carriers that provide vision benefits.
Plan Response:
The Plan disagrees with the finding for the following three reasons:
1. Because it’s brochure (First Payor) states that if a provider participates with both a
FEHB plan and a FEDVIP plan then the FEHB plan will pay benefits first and that
the FEDVIP plan allowance will be the prevailing charge in these cases;
2. Because it’s provider manual instructs it’s providers to coordinate benefits with the
FEHB plan as primary and then the Plan as secondary. The Plan relies upon its
providers because they “are in the unique position of having line of sight to which
FEHBP health plans particular enrollees are covered by and whether there are
potentially overlapping vision services.”
The Plan stressed that this policy was put in place as an exception to its normal
business due to the requirements of the FEDVIP contract and that it normally does
not coordinate vision benefits. In relation to fraud, the Plan stated that the actual
overlap of FEHB coverage and FEDVIP coverage is minimal, the Plan believes that
the actual risk of fraud in these cases is small; and
3. Lastly, because after it conducted a search of the claims paid during the scope of our
audit, it was unable to identify any claims that were coordinated with a FEHB carrier.
As part of its review the Plan concluded the following:
a. The main services provided by the FEHBP that would overlap with services that it
provides would be limited to examinations and resulting prescriptions written.
Lenses and frames are typically excluded from most FEHBP plans.
7 Report No. 1J-0B-00-16-063
This report is non-public and should not be further released unless authorized by the OIG, because it may contain confidential and/or proprietary
information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
b. Most FEHBP plans require that services are provided by a plan provider. This
would reduce the opportunity as the provider utilized by the member may not
participate with the FEHBP plan.
c. The COB process would require the provider to submit the Explanation of
Benefits (EOB) from the FEHBP plan to it along with the claim. If the provider
does not furnish it with this information it would be unaware of the provider’s
other contractual arrangements.
The Plan stated that it believes that these factors demonstrate the existence of a coordination of
benefits process.
OIG Comment:
While we understand the difficulties involved with coordinating vision benefits, we do not believe
that the Plan’s current processes meet the Contract requirements. This is because the Plan defers
the coordination of benefits process solely to its providers without a mechanism to identify or
track first payor claims.
Additionally, we find that the Plan’s review of its FEDVIP claims further supports our finding
because it states that if it is not provided an EOB from an FEHB provider, it would not know if
coordination had occurred. Although the Plan states that FEHB vision coverage is very limited,
our review found that approximately 48 percent of the FEHB Program carriers provide some type
of vision coverage.
C. Rate Proposal Review
The results of our review showed that the Plan had sufficient policies and procedures in place to
accurately develop its 2014 and 2015 FEDVIP rate proposals.
8 Report No. 1J-0B-00-16-063
This report is non-public and should not be further released unless authorized by the OIG, because it may contain confidential and/or proprietary
information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
APPENDIX
Specialty Benefits
6220 Old Dobbin Lane
Liberty 6, Suite 200
Columbia, MD 21045
May 5, 2017
Chief, Special Audits Group
U.S. Office of Personnel Management
Office of the Inspector General
800 Cranberry Woods Drive, Suite 270
Cranberry Township, PA 16066
RE: Comments to the Draft Audit Report No. 1J‐0B‐00‐16‐063
Dear :
On April 10, 2017, the United States Office of Personnel Management, Office of the Inspector General
(“OPM/OIG”) submitted to the UnitedHealthcare Vision Plan (the “Plan”) a “Draft Report” (1J‐0B‐00‐16‐
063) (“Draft Report”), detailing the results of its audit of the Federal Employees Dental and Vision
Insurance Program (“FEDVIP”) operations as administered by the Plan for contract years 2014 and 2015.
Upon submission, OPM/OIG requested that the Plan provide comments to the Draft Report.
The Plan appreciates the opportunity to respond to this Draft Report and the willingness of OPM to help
resolve the outstanding issues in this audit. The Plan has used its best efforts to obtain all relevant
information to respond to the Draft Report’s findings and recommendations. This Response will address
each issue presented in the Draft Report.
Coordination of Benefits
In its Draft Report, the auditors stated “The Plan did not coordinate benefits with Federal Employees
Health Benefits (FEHB) carriers in accordance with contract requirements.”
The Plan respectfully disagrees with this assertion for the following reasons:
1. The Plan Brochure clearly states on page 10:
“First Payor – When you visit a provider who participates with both , your FEHB plan and your
FEDVIP plan, the FEHB plan will pay benefits first. The FEDVIP plan allowance will be the
prevailing charge, in these cases.” [Please refer to Exhibit I – 2014 FEDVIP Brochure Excerpt]
Report No. 1J-0B-00-16-063
This report is non-public and should not be further released unless authorized by the OIG, because it may contain confidential and/or proprietary
information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
May 5, 2017
Page Two
2. The Plan has a coordination of benefits (“COB”) process which is documented in the Network
Administration Manual provided to all UnitedHealthcare Vision Plan providers. The policy on
page 27 states in part:
“The FEHB medical plan is primary and Spectera Eye care Networks is secondary. Submit
the following information to us……
A copy of the primary (medical) carrier’s EOB that shows the member’s liability and/or
service denials
A copy of the original CMS‐1500 claim form
You will note this policy is an exception implemented specifically for FEDVIP.
UnitedHealthcare Vision’s other commercial business follows the industry standard of not
coordinating benefits with other insurance plans or payers. [Please refer to Exhibit II –
Network Administration Manual Excerpt]
3. The Plan provided a response to the question of coordination of benefits in Information
Request 49 [Please refer to Exhibit III – IR49 with Plan Response]
The auditors also stated in the Draft Report “….the Plan is inadvertently permitting an avenue for potential
fraud where providers could coordinate with a FEHB carrier and also submit the claim to the Plan for full
reimbursement.”
The Plan does rely on its providers to adhere to the COB process as the providers are in the unique position
of having line of sight to which FEHBP health plans particular enrollees are covered by and whether there
are potentially overlapping vision services. Additionally, we believe that the risk for actual fraud is
minimal with FEDVIP in that there are only a small number of services that overlap between the vision
services offered through FEDVIP and those offered through the FEHBP carriers. For example, the vision
benefit offered through the FEHBP are primarily for Exam Only or medically based vision services (i.e.,
lenses following cataract surgery).
Therefore, the Plan believes that the information provided to the auditors during the audit and referenced
in this Response demonstrates the existence of a Coordination of Benefits process.
The Plan takes its contractual obligations very seriously and administers the FEDVIP in compliance with all
Federal regulations, contractual provisions and OPM instructions.
Report No. 1J-0B-00-16-063
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information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
May 5, 2017
Page Three
Once you have had the opportunity to review the information contained in this response, please contact
me if you have any questions or require additional information. Thank you for your ongoing cooperation
in bringing resolution to this audit.
Report No. 1J-0B-00-16-063
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information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
Exhibit I – 2014 FEDVIP Brochure Excerpt
Deleted by OIG – Not Relevant to Final Report
Exhibit II – Network Administration Manual Excerpt
Deleted by OIG – Not Relevant to Final Report
Exhibit III – IR49 with Plan Response
PLAN RESPONSE:
The Plan has conducted an extensive search for FEDVIP Vision claims during the scope of the
audit contract years 2014 and 2015 to determine if any required Coordination with another Payer.
The Plan was unable to locate any such claims.
In reviewing the claims data and discussing the COB process for vision with subject matter experts
from the Plan, we have concluded a few things about COB as it relates specifically to the FEDVIP
program and the manner in which the Plan administers the Vision benefit for FEDVIP members.
First, the instance of services provided by FEHBP carriers that would overlap with services provided
by FEDVIP are primarily limited to examinations (excluding contact examinations) and prescriptions
written as a result of those examinations. Typically lenses and other materials (i.e., frames) are
excluded under most FEHBP plans unless they are related to a medical condition (such as lenses
following cataract surgery).
Secondarily, the requirement of the majority of the FEHBP plans is for any vision services that
are covered must be performed by a Plan provider. This further reduces the opportunity for there
to be a circumstance where the provider is a Plan provider with an FEHB carrier and a
UnitedHealthcare Vision Panel provider at the time of service.
The process for COB to occur in those circumstances where there is a potential for services to
be covered by both an FEHBP and FEDVIP provider requires the Provider to submit the EOB
from the primary payer along with the claim for UnitedHealthcare Vision to review. If the Provider
does not furnish UnitedHealthcare Vision with this information, it is unlikely that the Plan would
have awareness of the Providers other contractual arrangements.
Finally, the member is paying for a level of benefit provided under their FEHBP carrier and they
are paying a separate premium for a level of benefit with their FEDVIP carrier. As long as the
provisions of the FEDVIP carrier are being administered according to the coverage level described,
the Federal Government is not being disadvantaged nor is the member gaining an unfair advantage
for the benefits provided.
For all of these reasons stated, it is the Plan’s position that it is not unreasonable that there are no
COB Vision claims to provide as examples for the 2014 and 2015 contract years.
Report No. 1J-0B-00-16-063
This report is non-public and should not be further released unless authorized by the OIG, because it may contain confidential and/or proprietary
information that may be protected by the Trade Secrets Act, 18 U.S.C. § 1905, or the Privacy Act, 5 U.S.C . § 552a.
Report Fraud, Waste, and
Mismanagement
Fraud, waste, and mismanagement in
Government concerns everyone: Office of
the Inspector General staff, agency
employees, and the general public. We
actively solicit allegations of any inefficient
and wasteful practices, fraud, and
mismanagement related to OPM programs
and operations. You can report allegations
to us in several ways:
By Internet: http://www.opm.gov/our-inspector-general/hotline-to-
report-fraud-waste-or-abuse
By Phone: Toll Free Number: (877) 499-7295
Washington Metro Area: (202) 606-2423
By Mail: Office of the Inspector General
U.S. Office of Personnel Management
1900 E Street, NW
Room 6400
Washington, DC 20415-1100
-- CAUTION --
This report has been distributed to Federal officials who are responsible for the administration of the subject program. This non-public version may
contain confidential and/or proprietary information, including information protected by the Trade Secrets Act, 18 U.S.C. § 1905, and the Privacy Act,
5 U.S.C § 552a. Therefore, while a redacted version of this report is available under the Freedom of Information Act and made publicly available on
the OIG webpage (http://www.opm.gov/our-inspector-general), this non-public version should not be further released unless authorized by the OIG.
Report No. 1J-0B-00-16-063
Audit of the Federal Employees Dental and Vision Insurance Program Operations as Administered by UnitedHealthcare Insurance Company for Contract Years 2014 and 2015
Published by the Office of Personnel Management, Office of Inspector General on 2017-09-29.
Below is a raw (and likely hideous) rendition of the original report. (PDF)