Dependent Eligibility Audit Finds 8.99% of Dependents Ineligible.

Business Situation

Client desired to engage an independent auditor to conduct an audit of all employees with enrolled dependents to confirm that all enrolled dependents met specific eligibility criteria defined by their plan. Client also wanted to establish an ongoing verification process for new enrollees.

Client Profile

  • Premier health care products manufacturer

  • 391 employees covering 1,212 dependents

Audit Results

  • 109 dependents (8.99%) failed to satisfy the plan’s eligibility criteria.

Audit Benefits

Client removed 109 dependents (8.99 % of total) from their plan, saving an estimated $270,000 and achieving a better internal understanding of their eligibility criteria. Additionally, they adopted changes to eligibility definitions to a more “employee-friendly” format.

Client Feedback

“BMI is clearly a well run organization. They gave us weekly updates and reports. We were always kept in the loop. Service level was spectacular. I would strongly recommend using BMI for a dependent audit. The services has turned out to be extremely beneficial in addition to the yearly savings our company will have going forward.”