HEALTH SOLUTIONS

Dependent Verification Services

Realize immediate cost savings while minimizing compliance risks

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As health care costs continue to rise, it’s more challenging than ever to provide the competitive benefits your people want while keeping your spend under control.

Each year, many organizations lose thousands, if not millions of dollars by covering dependents that are not eligible for their company-sponsored health plans. With our Dependent Verification Services, you can prevent this loss, ensure that only eligible dependents are covered, and stay compliant.

What is your dependent verification strategy?

The growing need for eligibility verification has made it the norm in the workplace and Alight has the dependent eligibility solution that is right for you. We provide one-time dependent audits to make sure all current dependents are eligible, ongoing dependent verification to ensure newly added dependents are eligible, and re-verification to make sure dependents whose relationships can change over time are still eligible.

Average return on investment of over 1700%

There are hidden costs in your health plan. Alight’s Dependent Verification Services help reduce your spend and increase net profitability. We find an average 5% to 7% of dependents ineligible in one-time audits and 10% to 14% of dependents ineligible in ongoing verification. With the average dependent cost over $4,000 per year and healthcare costs rising at a rapid rate, the savings from dependent verification add up fast.

Easy. Efficient. Personalized.

Our solution was developed to deliver the best possible experience for you and your people. How? We make the process simple and supportive. Our proprietary, industry-leading solution is customized to your organization's unique needs, while our user-friendly system and high-touch customer care support ensures that we are there for you and your people every step of the way.

Put the savings to use

Dependent eligibility verification reveals savings without reducing benefits or premiums. It’s no surprise it has proven to be one of the most effective healthcare cost-saving strategies. These are true dollar savings that can be put to good use, like finding the budget to fund other key initiatives.

Experience matters

Alight is a pioneer in dependent verification eligibility services. Our expertise ensures a smooth experience for you and your people and prevents the unexpected bumps that could come along the way. We’ve audited more than 8 million dependents from one-time audits and verify over a million dependents each year for our 350+ ongoing verification clients.

Stay compliant

The savings are huge. But dependent eligibility verification is more than just savings. By ensuring your plan only covers eligible dependents, you’re demonstrating fiduciary responsibility; reducing compliance risk under Sarbanes-Oxley, ERISA, and DOL guidelines and providing fair treatment for all employees.

Frequently asked questions

Have a particular question about Dependent Verification Services? We've answered some of the most commonly asked questions.

A dependent eligibility audit is a process used by organizations to verify that all dependents enrolled in a group benefit plan are eligible for coverage. Dependent eligibility audits require employees to provide documentation to validate the relationship between the employee and the dependent. This confirms the dependent is eligible for coverage based on the plan’s rules. Dependent eligibility audits are a best practice among employers and helps manage both regulatory compliance and rising health insurance costs. Dependent eligibility audits are predominantly used for health plan management, but can be applied to any group benefit plan that offers dependent coverage.

Employees often do not know or misunderstand the plan’s dependent eligibility rules and will unintentionally enroll ineligible dependents in the company health plan. Covering ineligible dependents costs both employers and employees significant dollars. Dependent eligibility verification protects the health plan from ineligible dependents, helping plan sponsors ensure their health plan is compliant and that benefit dollars are only being spent on participants who are eligible, keeping health care costs down for everyone.

Most plan participants who enroll an ineligible dependent are unaware of what they are doing and don’t know or understand their plan’s dependent eligibility rules. It’s rare for plan participants to intentionally enroll an ineligible dependent.

Eligibility for a group benefit plan will differ from plan to plan. However, the most common ineligible dependents on health benefit plans include: ex-spouses and ex-domestic partners, ex-step children, boyfriends and girlfriends, relatives that do not qualify as a dependent (such as parents or siblings) and personal staff (such as nannies or housekeepers).

There are two main ways to do dependent eligibility verification:

  1. A one-time, comprehensive dependent eligibility audit of enrolled dependents ensures that all dependents enrolled at the end of the audit are eligible.
  2. Ongoing verification for new dependents confirms eligibility of new dependents at the point of enrollment, ensuring only eligible dependents can enroll in benefits coverage.

Performing a comprehensive, one-time dependent eligibility audit followed by ongoing dependent verification is the best practice.

Documentation requirements will vary, but typically acceptable documentation is a legal document that validates the dependent’s relationship to the plan participant. For example, for a biological child, the child’s birth certificate, listing the child’s name and date of birth and listing the employee as the parent, is acceptable.

Watch our video to learn what dependent eligibility verification can do for your organization.

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