Understanding Dependent Verification

A dependent eligibility verification audit (or dependent audit) is a detailed review of all dependents enrolled in an employer’s health and welfare benefits plans to confirm they meet eligibility requirements. The audit examines documents like marriage licenses, birth certificates, adoption paperwork, and tax returns to verify the relationship and eligibility status of dependents. 

Conducting these audits on a regular basis enables organizations to identify ineligible dependents who should be removed from coverage. Common examples of ineligible dependents include: 

• Ex-spouses after a divorce 
• Stepchildren that are no longer part of the household 
• Children aging out of eligibility at 26 years old 
• Parents, grandparents, siblings, etc., outside plan guidelines 
• Ex-partners after a separation 

While painful, removing these ineligible dependents protects employers from improper liability and allows HR teams to rein in benefit spending. 

The dependent verification process step-by-step 

The typical dependent verification process involves three core steps: 

1. Employee outreach – HR teams first communicate details about the upcoming audit to all affected employees through emails, letters, FAQs, and other channels. This includes instructions on the documentation required, deadlines for submission, and implications of not responding.
2. Document collection – Over the next 4-8 weeks, employees submit the necessary documentation based on their dependent’s relationship – marriage licenses, birth certificates, etc. Digital document collection tools help streamline this process.
3. Dependent evaluation – Finally, HR staff or third-party partners carefully evaluate each document to confirm relationships and eligibility. Ineligible dependents are then removed from coverage. 

Ongoing verification at the time of enrollment prevents ineligible dependents from slipping through cracks in future years.