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DEPENDENT ELIGIBILITY AUDIT

This comprehensive audit report delves into the importance of dependent eligibility oversight in reducing costs and ensuring compliance with enrollment procedures. It highlights key areas such as responsible administration, communication strategies, and ongoing management support, providing a framework for effective audits that lead to significant savings—estimated at $2.25 million annually. With 4,376 employees with dependents and a 37:1 ROI, this initiative showcases the value of thorough documentation and proactive engagement in managing dependent eligibility.

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DEPENDENT ELIGIBILITY AUDIT

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  1. DEPENDENT ELIGIBILITY AUDIT

  2. Why do it? • Responsible Administration • Test of Enrollment Procedure • Cost Control • Test of Continuing Additions/Deletions • Providing Supporting Documents • Determining Eligibility

  3. Communications • Top Management Letter of Support • Newsletter – District wide • Union Agreement – • Vendor Direct Support • Telemarketing – Reminders

  4. Communications (con’t.) • Broadcast E-mails • Bulletin Board Postings • Mailings to the Home

  5. Results • Total Employee’s with Dependents-4376 • Total Dependents – 8910 • Total Dep. and Spouses removed – 1541 • Changed status from Fam. to Single – 291 • Estimated Premium Savings for 12 months - $2.25 Million (3.5% of Fully Insured Premium)

  6. Most Complied • Judged to be successful • ROI was 37:1!

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