| Dependent Eligibility Audits
Employers are keenly aware of their fiscal responsibility to control health care costs. Depending on employee demographics and complexity of the eligibility criteria, anywhere from 3-12% of most employers' dependents may be ineligible. By eliminating these ineligible dependents, employers can realize considerable savings in claims, premiums, administration fees, and other possible plan costs.
EFP understands the sensitive nature of the relationship between employers and their employees. EFP's flexible approach to verifying dependent eligibility provides the employer with many options by which to implement and communicate the necessity of the audit.
Our Comprehensive Method includes all covered dependents and provides the strongest level of assurance that only eligible dependents are enrolled in the plan.
Our Focused Method concentrates on covered dependents who may have circumstances indicating potential anomalies.
The Amnesty Program can be offered in conjunction with either method and provides enrolled employees an opportunity and incentive to voluntarily remove ineligible dependents.
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