Dependent Audit

Our clients have saved over $150 Million by removing ineligible dependents from their health and welfare plans1.

Why should my organization perform a Dependent Eligibility Audit?

Control Wasteful Spending

Dependent eligibility audits “often find that between 5% and 12% of employees had an ineligible dependent on a company health plan”2. These ineligible dependents are increasing your health care costs.

Comply with the Law

ERISA mandates that plan sponsors “manage plans for the exclusive benefit of participants and beneficiaries”3. Checking for ineligible dependents helps to ensure that your organization is meeting its fiduciary obligations. This also provides another internal control that helps your company comply with Sarbanes-Oxley.

Reduce Future Costs

Regular dependent eligibility audits show your employees that your organization is doing its best to minimize the costs of their health insurance. Auditing will also help stem future abuses of the eligibility provisions in your plan.

How does the Chapman Kelly Dependent Audit Process Work?

Our audit process and technology were built with the flexibility to meet each client’s unique needs.

  • Planning Phase – The timeline, communication and business rules are collaboratively established to meet your objectives and fit within your culture. Through our experience-based planning process, we can mitigate future issues and provide a more positive experience for your employees.
  • Amnesty Phase – This option provides an opportunity for ineligible dependents to be removed from the plan, generally with no repercussion to the employee. Your employee can have questions resolved by calling or faxing us toll-free, submitting questions via e-mail, or reviewing FAQs online.
  • Verification Phase – The employee is required to provide documentation that shows that enrolled dependents comply with the definition of an eligible dependent. Our purpose-built MAXTM technology provides a business rules engine to ensure accurate document processing.
  • Reporting – Throughout the audit process, you are given timely and insightful reporting that lets you see how the process is moving forward. Clients can access a custom-built, password-protected website that allows you to track all of the critical results of the audit.
  • Ongoing Audits – This option allows for annual or quarterly reviews of new or recently added dependents to ensure that ineligible dependents do not migrate back onto your plan. This ensures that the substantial savings generated during the dependent audit are realized year after year.

Why Choose Chapman Kelly?

Knowledge

  • We’ve helped hundreds of companies maximize value and minimize loss associated with health insurance and count over 35 Fortune 500 companies among our clients.
  • Our experience allows us to effectively deal with the most complex and difficult situations which may arise concerning dependent eligibility.
  • Our firm is solely focused on reducing the costs of healthcare. Each of our lines of business complements the others and provides our staff with unparalleled industry knowledge.

Technology

  • We utilize proprietary technology that we tailor to meet your technical environment, standard operating procedures and plan provisions.
  • Our internally developed MAX™ software platform has successfully processed hundreds of thousands of employee verification documents.

Results

"I was amazed at how well Chapman Kelly handled every complicated situation with ease. Chapman Kelly is obviously the best in the business at what they do. The right people were always in the right place at the right time."

– Connie Budzinski, National Grid

1. Based on an average expected yearly cost of $2,500 per ineligible dependent

2. The Wall Street Journal, To stem Abuses, Employers Audit Workers’ Health Claims, (New York, NY: March 2004)

3. http://www.dol.gov/compliance/guide/erisa.htm