Verify Eligibility, Reduce Risk: A Dependent Audit Case Study

Written by Allison Loehman | March 4, 2019

Employers have generally relied on the honor system for their health plan enrollment, and by doing so have unknowingly covered many non-eligible dependents such as ex-spouses, adult children and others. Unfortunately, this practice can translate directly into higher costs for the employer. In fact, as you assess your health costs after open enrollment, the most significant is often the cost of ineligible dependents.

benefitexpress has performed hundreds of dependent eligibility audits for enterprise-level clients across various industries with the main goal of helping organizations make their health dollars go further. Before taking cost-cutting measures that can negatively impact your employees, such as reducing benefits or increasing co-pays, we recommend going through the dependent eligibility verification process to identify potential dollars to put back into your budget. A carefully planned dependent eligibility audit can not only help employers uncover ineligible members and maximize health dollars, but it can improve compliance, reduce stop-loss exposure and minimize other litigation risks.

Keep reading to see how we helped a major healthcare organization reduce covered dependents by 3%, resulting in a cost savings of $2,000 per plan member per year, and a $674,000 annual savings.