Comprehensive Documentation Based Dependent Eligibility Audit Proves Effective
Business Situation
Following a scaled back dependent eligibility audit where employees were reminded of dependent eligibility requirements, no documentation was collected, and employees were allowed to voluntarily remove ineligible dependents, this client achieved limited savings. This year, the client chose BMI to conduct a comprehensive documentation based dependent eligibility audit to ensure that all dependents participating under the plan were currently valid based on the plan eligibility criteria.
Client Profile
Building Materials Distributor
365 employees covering 715 total dependents
Audit Finding
24 dependents (3.36%) failed to satisfy the plan’s eligibility criteria. A significant majority of those who failed were due to the fact the dependent’s employer offered group health coverage, but did not enroll despite being eligible.
Audit Benefits
The client terminated coverage for 24 dependents (3.36 % of total) saving well over $50,000 while saving internal administration time and money. An additional 22 dependents either did not respond to the audit or provided incomplete documentation and are being considered for removal. The savings obtained from the audit far outweighed the actual audit cost.
Client Advisor Feedback
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