Savings Follow Audit of Enrolled Dependents after Open Enrollment

Business Situation

This public entity wished to conduct a dependent eligibility audit of all enrolled dependents following open enrollment to ensure there was a “clean slate” going forward.

Client Profile

  • County Government

  • 876 Employees Covering 1,973 Dependents

Audit Finding

The client achieved a 97% employee response rate to the dependent verification process which resulted in:

  • 28 dependents (1.42% of total) failed to meet plan eligibility requirements.

  • Reasons for ineligibility included unreported divorces and voluntary removal at the audit’s onset.

Audit Outcome

The client terminated coverage immediately for the 28 dependents who were identified by the audit to be ineligible.  Additionally, coverage was terminated for 45 dependents who did not respond completely prior to the audit’s deadline despite multiple communications.

First Year Savings Calculations

Average Annual Cost per Dependent: $3,500 Estimated Annual Savings: $255,500 Return on Investment: 1,565%

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