Dependent Verification Audit

Are you covering more people than you intend?

With healthcare costs on the rise, many employers are looking for new ways to cut expenses. One place to start is by analyzing who you are covering under the existing healthcare plan. Making sure you cover only those who are eligible for the plan can result in a significant cost savings.

A dependent eligibility audit gives employers a detailed snapshot of dependents enrolled in the plan compared to a plan’s eligibility rules. In doing so, employers are able to identify dependents that should no longer be covered. Examples of ineligibility include children that have met the maximum age limit, divorced spouses, and children impacted by changes in custody arrangements. The goal isn’t to punish these individuals, but rather to make sure your organization is running at optimal efficiency.

Clearly, removing these ineligible dependents from the healthcare plan can translate into direct savings. But, there’s also a downside to allowing these individuals to stay on the plan. By not performing an audit, employers risk non-compliance with ERISA if they fail to comply with plan eligibility rules as provided in plan documents.

AIM regularly conducts audits – and they each look and feel different. The goal is to design an audit that meets legal standards and matches your organization’s way of doing things. An audit can feel like an invasive process; AIM specializes in ensuring that employees understand its importance and value. From strategy to specific document review, AIM can be a partner in your eligibility audit, at any level.

To learn more about why you should consider a Dependent Eligibility Audit, read our article, Dependent Eligibility Audits: Controlling the Cost of Healthcare.