A comprehensive dependent eligibility audit is a complete documentation-based verification audit of all enrolled dependents within an organization’s health plan(s). This is an industry standard and most popular among all employers. The process is relatively quick, conducted primarily through mail or email and lasts a few months at most. Most professional firms offer the assistance of a Call Center and website to assist employees with completing verification process. In addition, some firms can also make recommendations to clarify plan language and eradicate discrepancies. The end result leaves the employer with an accurate list of dependents that failed to meet the employer’s specific eligibility requirements.

Few forms of health care cost containment activities provide such immediate savings. Given the fact that the average dependent can cost an employer a minimum of $3,000 annually, it’s not uncommon for an employer to achieve returns on investment ranging from 100% to over 5,000%. It is important to note that these savings continue each year following the audit had the ineligible dependent remained enrolled.

This type of dependent eligibility audit may be ideal if the organization has:

  • Never conducted a dependent eligibility audit.
  • Not conducted an audit within the last 2 years.
  • Experienced high turnover or acquisitions.
  • Made significant changes in their coverage or eligibility rules.
  • No consistent method of documenting or verifying eligibility of enrolled dependents.