Dependent Eligibility Verification

Posted by BAS - 12 April, 2012

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Statistics show that often employers spend a large amount of their health care dollars on coverage for non-eligible dependents. When health coverage is available to dependents of employees, employers may wish to closely monitor those individuals who are enrolled in the plan under dependent status.

Eligibility rules are unique to each employer's plan. If an employer's HR department does not monitor eligibility, ineligible individuals may inadvertently be extended health benefits.

A dependent eligibility audit is one way of making sure health plan dollars are properly extended for coverage. Through an audit, employees can be required to provide supporting documentation for individuals they cover as dependents under the plan. Birth certificates, marriage certificates, etc. may be requested to "prove" dependent status. Employers conducting dependent eligibility audits do have to be careful about questions asked about children covered under the plan. Under health care reform, a medical plan that covers children must extend that coverage up to the age of 26, without any requirements other than the relationship of the child to the employee (for example, through a birth certificate). Tax returns may not be required for justifying a parent-child dependency relationship.

BAS' Dependent Eligibility Verification Service offers employers the ability to save money on health care expenditures by limiting plan coverage to eligible dependents, only. Contact sales@BASusa.com for more information.

Topics: HR & Benefits Compliance


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