Ongoing Savings with Ongoing Dependent Eligibility Audits
Business Situation & Client Profiles
Following an initial audit, many clients rely on BMI for ongoing dependent eligibility audits. Circumstances such as life events, new hires, open enrollment or acquisitions combined with an employer’s limited internal resources, are often a driving factor to continue to utilize our expertise to ensure ineligible dependents don’t continue to remain on the plan.
Solution
BMI customizes audit plans to meet the following goals:
On an ongoing basis, communicate the purpose of the audit, deadlines, requirements, etc. to all employees with recently enrolled dependents.
Provide a customer service department with toll-free phone lines and bilingual staff.
Compare plan eligibility requirements with documentation submitted.
Identify all dependents recently enrolled who do not meet eligibility criteria.
Securely collect and retain all verification documentation.
Report findings weekly and provide a final summary of results.
Findings
Unreported divorces
Dependents eligible for other coverage
Overage dependents
Voluntary requests for removal
Audit Outcomes
Manufacturer with 1,610 Employees Audit 1 Audit 2 Audit 3 Audit 4
Number of dependents removed: 117 136 111 84
Calculated savings from deps removed: $462,528 $755,162 $703,857 $294,000
Return on investment: 1,369% 1,949% 1,989% 891%
School District with 850 Employees Audit 1 Audit 2 Audit 3 Audit 4
Number of dependents removed: 101 25 15 to date not started
Calculated savings from deps removed: $353,500 $87,500 $60,000 not started
Return on investment: 1,629% 932% TBD% not started