NEW JERSEY’S PERSPECTIVE ON REDUCING IMPROPER BENEFIT PAYMENTS

NJ BPC PRESENTERS JOHN C. GALVIN BUREAU CHIEF – 2008 TO CURRENT SUPERVISOR OF INVESTIGATIONS TO 2008 SUPERVISING INVESTIGATOR TO 1999 UI INVESTIGATOR-1982 TO 1992 B.A. SOCIOLOGY/CRIMINAL JUSTICE – RICHARD STOCKTON STATE COLLEGE 1974 MICHAEL B. MARICH SUPERVISOR OF INVESTIGATIONS TO CURRENT UI APPEAL EXAMINER 2000 TO 2003 UI INVESTIGATOR 1998 TO 2000 B.S. ENVIRONMENTAL POLICY-RUTGERS UNIVERSITY 1996

NEW JERSEY‘S BUREAU OF BENEFIT PAYMENT CONTROL INVESTIGATIONS SECTION CLAIMS CONTROL REFUND PROCESSING SECTION ADMINISTRATION PERSONNEL BUDGETED ALLOCATION: 102 EMPLOYEES ON-BOARD: 64 EMPLOYEES

NEW JERSEY’S DIVISION OF UNEMPLOYMENT INSURANCE 2009 BENEFITS PAID= $ 8,000,000, (8 BILLION) 2009 UI CLAIMANTS = 700,000 (APPROXIMATELY)

CURRENT NJ TRADITIONAL CROSS MATCH “OUR BREAD & BUTTER” HOW IT WORKS

NJDLWD ANCILLARY CROSS MATCHES NATIONAL DIRECTORY OF NEW HIRES NJ DEPARTMENT OF CORRECTIONS CROSS MATCH SOCIAL SECURITY DEATH LIST CROSS MATCH

NATIONAL DIRECTORY OF NEW HIRE REPORTED DATE OF HIRE MATCHED AGAINST WEEKLY UI ROLES CLAIMANT CONTACTED VIA USPS AND INFORMED OF DATE OF HIRE RECEIVED IF CLAIMANT DISPUTES DATE OF HIRE EMPLOYER IS CONTACTED FOR DOCUMENTATION OF WAGES AND FDW DETERMINATION OF ELIGIBILITY RENDERED

NJ DEPARTMENT OF CORRECTIONS CROSS MATCH REPORTED DATE OF INCARCERATION MATCHED AGAINST UI ROLES ON A MONTHLY BASIS PEND UI CLAIM AND CONTACT CLAIM ANT VIA USPS FACT-FINDING NOTICE RENDER DETERMINATION OF ELIGIBILITY BASED ON RESPONSE OR LACK OF RESPONSE

SOCIAL SECURITY DEATH LIST CROSS MATCH INITIAL CLAIMS PROCESSING APPLICATION MATCHED AGAINST SSA DEATH LIST VIA VERIS IF SSN APPEARS ON DEATH LIST CLAIM PENDED FOR VERIFICATION RENDER DETERMINATION OF ELIGIBILITY

RECOMMENDATIONS FOR ANCILLARY CROSS MATCHES ADJUST ALL CROSS MATCHES FROM THEIR MONTHLY, WEEKLY, OR INITIAL APPLICATION PROCESS TO THE ON-GOING BI-WEEKLY CLAIM CERTIFICATION SCHEDULE NDNH LEGISLATION MANDATING ALL EMPLOYERS TO REPORT THE ACTUAL FIRST DAY OF WORK FOR ALL NEW AND REHIRED EMPLOYEES PROGRAMMING CHANGES TO AUTOMATICALLY FLAG UI CLAIMS WHEN FDW, DATE OF INCARCERATION, OR SSA DATE OF DEATH CONFLICTS WITH THE CURRENT UI CERTIFICATION FOR BENEFITS FLAGGED CLAIMS ARE FORWARDED TO A TELEPHONE AGENT WHO MUST PRESENT CLAIMANT WITH POINT OF CONTROVERSY. (DECEASED, IN-JAIL, OR CURRENTLY WORKING) DEPENDING ON CLAIMANTS RESPONSE TO CONTROVERSY TAKE APPROPRIATE ACTION TO ADJUDICATE ELIGIBILITY

CURRENT NJ DLWD EMPLOYER UI BENEFIT CHARGE NOTIFICATIONS CURRENTLY ALL UI BENEFIT CHARGE NOTICES ARE MAILED VIA USPS ON A QUARTERLY BASIS. BPC MAILS OUT IN EXCESS OF 100,000 NOTICES EVERY QUARTER OF EVERY YEAR CHARGE NOTICES REPORT WEEKLY BENEFIT CHARGES FOR ALL CLAIMANTS COLLECTING BENEFITS DURING THE QUARTER. THIS CREATES A POTENTIAL 13 WEEK DELAY IN NOTIFICATION TO THE EMPLOYER EMPLOYERS ARE REQUIRED TO REPORT ABUSE OR PROTEST CHARGES VIA RETURN OF CHARGE NOTICE TO BPC

PROPOSED NJ DLWD EMPLOYER BENEFIT CHARGE NOTIFICATIONS MAKE CHARGE NOTIFICATIONS AVAILABLE IN REAL TIME AS WEEKLY BENEFITS ARE PAID PUT RESPONSIBILITY FOR OBTAINING THE INFORMATION ON THE EMPLOYER PROVIDE A PORTAL FOR ALL EMPLOYERS TO SECURELY ACCESS THEIR CHARGE STATEMENTS AND REPORT BENEFIT ABUSE OR PROTEST OF CHARGES

CURRENT NJDLWD OVERPAYMENT FRAUD SANCTIONS FULL RESTITUTION OF ALL BENEFIT DOLLARS COLLECTED FRAUDULENTLY ONE YEAR DISQUALIFICATION FOR BENEFITS FROM DATE OF DISCOVERY OF FRAUD OVERPAYMENT FINES OF $20.00 PER WEEK OR 25% OF THE PRINCIPAL AMOUNT OF BENEFITS COLLECTED FRAUDULENTLY JUDGMENT FILED AND INTEREST TO ACCRUE IF NO FORMAL AGREEMENT TO REPAY HAS BEEN ENTERED INTO AND NO RESTITUTION MADE WITHIN 180 FROM THE DATE OF DISCOVERY

RECOMMENDED NJDLWD FRAUD SANCTIONS FULL RESTITUTION OF ALL BENEFIT DOLLARS COLLECTED FRAUDULENTLY 1 ST OFFENSE – FINES OF $20.00 PER WEEK OR 25% OF THE PRINCIPAL AMOUNT OF BENEFITS COLLECTED FRAUDULENTLY. JUDGMENT FILED AND INTEREST WILL ACCRUE 2 ND OFFENSE – ONE YEAR DISQUALIFICATION FOR BENEFITS FROM THE DATE OF DISCOVERY. FINES OF $20.00 PER WEEK OR 25% OF THE PRINCIPAL AMOUNT OF BENEFITS COLLECTED FRAUDULENTLY. JUDGMENT FILED AND INTEREST TO ACCRUE IF NO FORMAL AGREEMENT TO REPAY HAS BEEN ENTERED INTO AND NO RESTITUTION MADE WITHIN 180 FROM THE DATE OF DISCOVERY 3 RD OFFENSE – LIFETIME INELIGIBILITY FROM NEW JERSEY UNEMPLOYMENT INSURANCE

OTHER MEASURES IMPLEMENTED OR REQUIRING IMPLEMENTATION TO REDUCE BENEFIT OVERPAYMENTS ALLOW UI LOCAL OFFICE STAFF (NON –BPC) THE AUTHORITY TO CREATE LOW DOLLAR OVERPAYMENT REFUNDS WHEN THE OVERPAYMENT IS DETERMINED NON-FRAUD WORK SEARCH VERIFICATIONS ISSUE DEBIT CARDS TO REDUCE THE THEFT AND FORGING OF PAPER CHECKS

FEDERAL INCENTIVE ASSISTANCE CHANGE THE FEDERAL GOVERNMENT’S FOCUS FROM THE ACCEPTABLE LEVEL OF PERFORMANCE (ALP) AND THE GOVERNMENT PERFORMANCE AND RESULTS ACT (GPRA) OR DETECTION BASED MEASURE TO AN OVERPAYMENT PREVENTION MEASURE. SINCE BOTH THE ALP AND GPRA MEASURES ASSESS THE RECOVERY/SETUP OF OVERPAID BENEFITS, THERE IS NO INCENTIVE FOR STATES TO FOCUS ON PREVENTIVE MEASURES LIKE ALL THOSE WE HAVE DISCUSSED TODAY.