Businesses Increasingly Auditing Employees To Ensure Dependents Eligible For Health Insurance

Main Category: Health Insurance / Medical Insurance
Article Date: 15 Jan 2008 - 12:00 PDT

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Businesses increasingly are conducting insurance audits of employees to ensure that all dependents are eligible for health benefits, Newhouse/Houston Chronicle reports. Some consultants say that, on average, about 3% to 12% of dependents enrolled in an employer-sponsored health plan are not eligible. According to Newhouse/Chronicle, "With insurance costs rising faster than inflation for a decade," the money saved by an audit "quickly dwarfs the expense of conducting an audit."

Daniel Priga, a principal for Mercer, said, "There has been a significant growth of interest in conducting these types of reviews." Susan Johnson, a senior consultant at Watson Wyatt Worldwide, said that use of insurance audits has "grown exponentially in the last 18 months." According to Johnson, the audits are most common in "high turnover industries," such as service, retail and banking.

Audits typically begin with a reminder to employees about which dependents qualify for coverage and an explanation of the proof that will be required to maintain benefits for dependents. Many employers offer an amnesty period when employees can remove dependents from the plans without penalty. Consultants say many of the problems uncovered during an audit are unintentional and result from "inattention or honest errors," Newhouse/Chronicle reports. Common areas of confusion or oversight include a child dropping out of full-time higher education, divorce changing a dependent's status and marriage changing a dependent's status, according to Newhouse/Chronicle.

GM Audit
General Motors is in the process of auditing its entire work force of about one million employees and their dependents, according to Michelle Bunker, a spokesperson for the automaker. Bunker said, "For every one [dependent] that we drop, it's about $1,000 savings."

Newhouse/Chronicle reports that Chrysler Group and Ford Motor spokespeople said the automakers in the past have audited their employees and that both have removed thousands of ineligible dependents from their rolls. In addition, both automakers have allowed amnesty periods, according to Newhouse/Chronicle (Reynolds Lewis, Newhouse/Houston Chronicle, 1/12).

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