Dependent Eligibility Audits May Produce Savings

Like every other aspect of business today, employees and their dependents are in a constant state of change these days. Even before healthcare reform extended the eligible age of dependent children to 26, changes in family status usually caused at least 10 percent of employees to have dependents enrolled in a group health plan who no longer satisfied the eligibility definition of health plan documents.

Eliminate Waste and Capture Savings

Dependent eligibility audits help identify ineligible dependents so they may be terminated from your benefit plan, creating an immediate savings as well as an opportunity for fewer claims going forward. These audits also provide a more realistic basis for future health-care benefit planning and budgeting.

The process usually begins with the review of plan and eligibility documents, followed by distribution of audit materials to all employees, gathering of responses and verification of all responses received. After the results of the audit are complete, summary reports are issued to management and action items, including savings projections, are determined.

At an average, annual cost of $2,500 per-dependent, an organization with 300 employees could easily realize a savings of $75,000 within one year of an audit. And once costs are reduced from such an audit, they stay reduced for many years.

For more information on our dependent eligibility audit services, or to discuss the potential savings available to your organization, simply call us or send us an e-mail today.