Small Group Achieves Big Savings from Dependent Eligibility Audit
Business Situation
This client came to us to identify any enrollees who did not meet eligibility criteria so that they could remove them to comply with ERISA requirements.
Client Profile
Real Estate
548 Employees Covering 1,137 Dependents
Audit Finding
22 dependents (1.93% of total) were determined to be ineligible, many of whom were enrolled as spouses but were ineligible because they were legally divorced, unmarried or failed to meet domestic partnership requirements.
7 dependents (.62% of total) were incomplete.
54 dependents (4.75% of total) did not respond to the audit request.
Audit Benefits
The client terminated coverage immediately for the 22 ineligible dependents who failed the audit requirements and 61 dependents who did not complete the audit prior to the 4th and final deadline.
First Year Savings Calculations
Average annual cost per dependent:
$3,500
Annual savings for dependents removed:
$290,500
Return on Investment:
2,471%