Dependent Eligibility Audits

Dependent Eligibility Audit

Dependent Eligibility Audits

The discovery and removal of ineligible dependent / dependents will be significant as they cost you and your employees money. By reducing these healthcare costs, an employer is able to provide the most comprehensive benefits at the best value, which is a win‐win situation for the employer and the employee. 

Ineligible dependents put a strain on company resources, while also increasing healthcare costsfor both the employer and employees. Employers can reduce unnecessary costs by conducting thorough audits and removing ineligible dependents from benefit programs, thusbenefiting the organizations financial well-being. This cost-cutting technique allows businesses to offer more comprehensive benefits at a better value, resulting in a win-win situation. Employees gain from improved healthcare options, while companies improve their capacity to competitively offer these options. In summary, identifying and removing ineligible dependents is a strategic move that aligns the interests of both businesses and employees in creating a more sustainable and value-driven employee benefits program. 

Secova’s Dependent Eligibility Verification Auditservicein United Statesis carried out with a strong emphasis on sensitivity, ensuring that employees are guided through the verification process with transparency and empathy. The audit process is intended to describe the reasons why a dependant may be ineligible, giving employees a complete understanding of the criteria involved. By defining each phase of the verification process, the company reduces confusion and ambiguity while alsocreating trust and clarity. This strategy not only minimizes adverse employee reactions, but it also contributes to the maintenance of positive employee relations. Employees appreciate open communication and are more willing to cooperate when they understand the audits goal and necessity. Ultimately, a Dependent Eligibility Verification Audit service conducted with sensitivity and clear communication not only assures compliance with eligibility criteria, but also contributes to a positive workplace culture by emphasizing transparency and empathy in the benefits administration process.

Secova’s Dependent Eligibility Verification Audit handles verifications with sensitivity, ensuring employees understand exactly why a dependent may be ineligible and explaining the process every step of the way, which, in turn, eliminates adverse employee reaction and helps maintain employee goodwill.

  • Ensure your employees are getting the maximum out of their benefit schemes
  • Get all data for your organization up-to-date including that for employee life events
  • Remove all ineligibilities / ineligible dependents
  • Reduce compliance risk under ERISA & DOL guidelines
  • Guaranteed Organization Savings of 6-10% after audit cost

Our Standard Dependent Eligibility Verification Audit Process Includes:

  • Set-up of a project management team in place from planning to completion
  • Progress report calls to keep you aware of any updates about the verification process
  • A project analysis and recommendation presentation to identify specific savings, ROI, and to ensure post-audit compliance with your eligibility rules

Keep the Savings Coming

Without continued dependent eligibility verification, the risk of ineligible dependents increases significantly, potentially reverting to pre-audit levels in three to five years. The necessity of ongoing examination cannot be emphasized enough as changes in items like family structures, life events, and eligibility criteria might result in errors over time. We solve this difficulty through Ongoing Dependent Eligibility Management, which takes a proactive and systematic approach to ensuring that enrolees continually meet eligibility standards for coverage. This ongoing procedure includes regular reviews and revisions to prevent the growth of ineligible dependents and ensure the benefits program’s integrity.

Requesting, Collecting, Auditing and Maintaining:

  • Eligibility verification documentation from newly enrolling dependents
  • Recertification verification documentation on a regular basis
  • Secure online access to Secova’s Dependent Eligibility Management System to view and manage documentation
  • Compliance consulting support for benefit administrators

We are always happy to review your existing benefit portfolio. We often find after completing a review that we can save money or offer a richer benefit program. We are committed to keeping our clients educated on the constant changes regarding health insurance benefits. Contact us with any questions regarding your benefit needs.

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