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Dependent eligibility verification audit

Article 12.15.2015 Dean Dorton

Most companies want to provide their employees with the best medical benefit coverage; however, healthcare costs and the cost of medical insurance continue to increase. One way to help reduce your costs is a dependent eligibility verification audit.

It is estimated that 4% to 8% of dependents nationwide are ineligible to participate in their company’s medical plan. It is also estimated that a company’s annual average cost of medical coverage for a dependent is approximately $3,300. We have seen these national estimates hold true in the clients that we have worked with in the past year.

So how do you identify the ineligible dependents?

The best way is to conduct a dependent eligibility verification audit. Your company can perform this audit, or a third party can be brought in to assist you. Dean Dorton would be happy to guide you through the process and perform the audit for you. Dependent eligibility verification audits can be very sensitive. They are very time consuming if it is not done properly, and dependents could be wrongly removed from the plan, upsetting employees.

The goals of a dependent eligibility verification audit are to achieve a high response rate from your employees and to make sure that only those who are ineligible for coverage are removed – not to remove the maximum number of dependents in the shortest period of time. We highly recommend partnering with Dean Dorton because we are trained and experienced in performing audits. Our services are designed to:

  • Meet the specific needs and objectives of each client
  • Achieve the highest response rate and compliance rate
  • Properly handle a significant volume of confidential data
  • Provide open, strong communication channels with employees and management
  • Provide value and cost savings

If you would like to learn more about the solutions we can provide, please contact Jim Tencza at (502) 566-1071 or jtencza@deandorton.com to set up a consultation today.


View Jim Tencza’s Bio

Filed Under: Audit and Assurance, Healthcare Tagged With: Audit, Benefit, Dependent, Dependent eligibility verification audit, Healthcare, Insurance, Jim Tencza, Medical

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