Dependent Eligibility Audit
Ineligible dependents cost businesses millions of dollars in annual health plan expenses. Rather than implementing cost-cutting measures like reducing benefits or increasing co-pays (which employees are not fans of), dependent eligibility audits can identify those individuals who are not eligible to participate in a company’s benefit plan. Dependent eligibility audits are a best practice in employee benefits.
By ensuring that only eligible participants are receiving coverage, you can save money and stay compliant. If you’re self-funded, you can eliminate stop-loss exposure and ERISA violations if applicable and SOX issues (if you’re a public company). The monetary savings to the employer can be significant, with an average of 6% of covered dependents deemed ineligible for continued coverage.
Why Dependent Verification?
Reduce medical premiums for fully-insured plans and claims costs for self-insured plans
Improve compliance with your Summary Plan Descriptions (SPDs), HR policies and rules
Reduce stop-loss exposure and litigation risk related to ERISA, Sarbanes-Oxley and other regulations
How Much Could You Save with a Dependent Verification Audit?
We’ve found that, on average, 6% of dependents listed on benefits plans are ineligible. What does that mean to you? $10,000? $100,000? More? Run a few scenarios on our Dependent Eligibility Savings Calculator and see how high your potential savings could be!
What is the Verification Process?
Best Practices for Dependent Verification
Conduct an amnesty-style audit after you’ve concluded open enrollment
Get buy- in from unions and other stakeholders in advance
Use a third-party to conduct the audit to protect the employee-employer relationship
Communicate clearly and often with employees about the audit process and deadlines
Provide positive and clear communications to employees using multiple communication channels