Dependent Eligibility Audits
Is your organization doing enough to help reduce the cost of providing health care coverage to your employees?
Are you looking to reduce your current and future healthcare costs?
Employers struggling to reduce their Healthcare spending are discovering that Dependent Eligibility Audits can dramatically reduce their costs both today and for the future.
Employers struggling to reduce their Healthcare spending are discovering that Dependent Eligibility Audits can dramatically reduce their costs both today and for the future.
Covering
and paying for the health benefits of individuals who are not eligible is more common than expected. Approximately
4% to 8% of
the dependents on any plan are may be ineligible for coverage after a thorough and comprehensive Dependent Eligibility Audit is conducted.
Healthcare
costs are continuing to rise and the economy is wreaking havoc on the financial strength of employers regardless of size. In addition
to the financial struggles, employers are also required to be more vigilant than ever about compliance. ERISA and Sarbanes- Oxley
both have provisions that demand higher levels of controls over healthcare spending and reduction of risk.
With Healthcare Reform
and other such provisions, it is very important for employers make sure every dependent they are covering is actually eligible for
coverage. The shift towards mandating that employers provide dependent coverage later into a young adult’s life (up to age 26)
will result in higher costs for employers.
Control Wasteful Healthcare Spending
Dependent eligibility audits often find that between 4% and 8% of employees have an ineligible dependent on your company's health plan. These ineligible dependents can increase your company's health care costs substantially.
Dependent eligibility audits often find that between 4% and 8% of employees have an ineligible dependent on your company's health plan. These ineligible dependents can increase your company's health care costs substantially.
Comply
with the Law and Avoid Costly Fines and Penalties
ERISA mandates that plan sponsors “manage plans for the exclusive benefit of qualified, eligible participants and beneficiaries. Checking for ineligible dependents helps to ensure that your organization is meeting its fiduciary obligations while complying with applicable law.. The audit also provides another internal control that will help your company to comply with Sarbanes-Oxley.
ERISA mandates that plan sponsors “manage plans for the exclusive benefit of qualified, eligible participants and beneficiaries. Checking for ineligible dependents helps to ensure that your organization is meeting its fiduciary obligations while complying with applicable law.. The audit also provides another internal control that will help your company to comply with Sarbanes-Oxley.
Reduce Future Healthcare Costs
Regular dependent eligibility audits show your employees that your organization is doing its best to minimize the costs of their health insurance. Auditing will also help stem future abuses of the eligibility provisions in your plan.
Regular dependent eligibility audits show your employees that your organization is doing its best to minimize the costs of their health insurance. Auditing will also help stem future abuses of the eligibility provisions in your plan.
How Does The Audit Process Work
Planning Phase – The timeline, communication and business rules are collaboratively established to meet your objectives and fit within your culture. Through the experience-based planning process, we can mitigate future issues and provide a more positive experience for your employees.
Amnesty Phase – This phase provides an opportunity for ineligible dependents to be removed from the plan, generally with no repercussion to the employee. Your employee can have questions resolved by calling or faxing us toll-free, submitting questions via e-mail, or reviewing FAQs online.
Verification Phase – The employee is required to provide documentation that shows that enrolled dependents comply with the definition of an eligible dependent. Our purpose-built MAXTM technology provides a business rules engine to ensure accurate document processing.
Reporting – Throughout the audit process, you are given timely and insightful reporting that lets you see how the audit is moving forward. You can access a custom-built, password-protected website that allows you to track all of the critical results of the audit.
Ongoing Audits – This option allows you to conduct annual or quarterly reviews of new or recently added dependents to ensure that ineligible dependents do not migrate back onto your plan. This ensures that the substantial savings generated during the dependent audit are realized year after year.
Services Provided By Dependent Check
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