You’ve just survived another open enrollment.  What do you do now?  Go to Disney World!  Well, as soon as you return, you should consider doing a dependent eligibility audit.  Right after open enrollment is the point in the year where your enrollment information is as good as it gets. That makes this the perfect time to verify enrollment facts and collect the documents needed to prove that:

1. Enrolled family members are really eligible;
2. Payers loaded the new open enrollment facts correctly;
3. Payers are fully pursuing all opportunities for recoveries from other plans and Medicare; and
4. Employees who did not respond or change anything during open enrollment (usually a majority) are not hiding a change in eligibility (like a divorce) they’d rather you didn’t know.

A dependent eligibility audit also lets enrollees correct input errors that creep into any complex data gathering process like open enrollments.  It is also an ideal time for employers to get other information not part of open enrollment (like spousal employment information which has become very popular with the rise in spousal opt-out programs).

Dependent eligibility audits make sense for all these (and other) reasons any time of the year.  But right after open enrollment is by far the best time to think about doing this and making it a normal part of your annual activity.

You can read more about dependent eligibility audits here, or contact us for more information