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Allergy season, muscle cars, space shuttle launches...and Dependent Eligibility Audits?
Keith Bird, VP of Sales for AmWINS came on the Self-Funded with Spencer Podcast to discuss the fiduciary responsibility that Self-Funded Employers have to ensure the dependents enrolled on their health plan are eligible to be there.
Unless you have a good way of validating the eligibility of enrollees manually (you probably don't) then you likely have dependents on your plan today that are not supposed to be there.
Keith estimates that about 3% of dependents on average on any given plan are not eligible. Whether it is a person enrolled as a spouse when they actually aren't married, or an enrolled child on the plan that turns out to be a cousin, the cost of healthcare is so great that many people find the need to defraud their employers for coverage.
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