Dependent Eligibility Audits

Frequently Asked Questions

How much will my HR Staff be involved?
Your headquarter’s staff will participate in the initial planning meetings of the audit and review draft communication materials. Once the actual audit begins, the Center for Benefits Management will be responsible for the process. At that point, your field HR representatives will be provided with updates and asked to encourage employee participation.

How long will the process take?
The entire audit process will take approximately 5 months. This includes the planning phase, an optional amnesty period, the execution of the audit and a summary of the results. Accelerated options are also available, if necessary.

What kind of documentation will my employees need to provide?
Each health care plan has language that describes who is eligible for coverage.  However, rarely does a plan state specifically what documentation might be required as “proof” of eligibility. Generally, to verify dependent eligibility, an employee will need to have some combination of the following documents:

  • Birth Certificates
  • Marriage Certificates
  • Divorce Decrees
  • Tax Returns
What are the most important decisions that an Employer needs to make?
We will facilitate the decision making process and help you understand each option and the implications. Some examples include:
  • What documentation will be required as proof?
  • When will ineligible dependents lose coverage?
  • Will an amnesty period be offered?
  • Will COBRA be offered to ineligible dependents?
  • How will appeals be handled?
 What are the keys to a successful audit?
  • Simple and understandable communication materials
  • Use of Employer letterhead to improve response
  • Timely and professional handling of employee submissions and inquiries
  • Support of Human Resource staff
How can I ensure that employee information is safe?
The Center for Benefits Management realizes the critical nature of the information that is supplied to us by employees and considers it private and confidential. We will keep this data protected throughout the audit and either destroy the documents collected or return them to Human Resources at the conclusion of the project.