Dependent Eligibility Verification is a simple solution to a complex issue – ensuring that every dependent covered is actually eligible for coverage.
Many employers now see the growing need for eligibility verification. The Employee Retirement Income Security Act and Sarbanes-Oxley both demand stringent healthcare cost control. With the Affordable Care Act requiring employers to cover adult children up to age 26, it is increasingly important that your plan only covers those that it should.
Let’s face it. Some dependents on your plan do not meet the eligibility criteria. This can be a huge financial drain. A verification will reveal the ineligible dependents which reduces your spending and directly increases your net profitability.
And the cost is affordable. In fact, the savings from a reduction of just .25 percent to .5 percent of a plan’s enrolled dependents generally covers the cost.
The HMS Difference
From the more than 2,000 Dependent Eligibility Verifications conducted by HMS, we experience an average employee response rate of 95 percent, with verifications completed in less than 100 days.
HMS handles verifications with sensitivity, ensuring employees understand exactly why a dependent may be ineligible, and explaining the process every step of the way. We’re experienced. We have reviewed more than 5.6 million dependents and our experience ensures plans only pay fees for dependents who are eligible for coverage.
HMS’s Dependent Eligibility Verification was built with flexibility in mind. Because new dependents are added to health plans throughout the year for a number of reasons, ineligible dependents may find their way onto a plan at any time. That’s why we customize the review to meet your needs and offer verification options: