Maximizing ROI with Ongoing Verification

Business Situation & Client Profile

Many clients rely on BMI for ongoing dependent eligibility verification after an initial audit. Circumstances like life events, new hires, open enrollment, or acquisitions, combined with an employer’s limited internal resources, are often a driving factor in utilizing BMI’s expertise to ensure ineligible dependents don’t remain on the plan.

Solution

BMI customized an ongoing plan to meet the following objectives:

  • Communicate the purpose, deadlines, and compliance requirements to all applicable employees and their enrolled dependents.

  • Provide a customer service team with toll-free phone lines and bilingual staff.

  • Compare eligibility requirements with the documentation submitted.

  • Identify dependents recently enrolled who do not meet eligibility criteria.

  • Securely collect all verification documentation.

  • Report findings and provide a summary of results.

Audit Findings

  • Unreported divorces

  • Dependents eligible for other coverage

  • Over-age dependents

  • Voluntary requests for removal

Audit Outcome & Calculated Savings:

Through six active verification groups, the removal of recently enrolled ineligible dependents from the plan generated an impressive $791,000 in savings and positive ROIs for each group.

Table Chart
Audit # # of Dependents Savings from Removed Dependents ROI
1 101 $353,500 1,629%
2 25 $87,500 932%
3 15 $60,000 595%
4 11 $55,000 545%
5 22 $110,000 1,063%
6 25 $125,000 1,065%
 
Dependent EligibilityRobert Temples