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Introducing Findley Davies' New Suite of Dependent Eligibility Audit Services: TbV4
Date:8/15/2008

TOLEDO, Ohio, Aug. 15 /PRNewswire/ -- Auditing health plans to determine if covered dependents meet eligibility requirements is not a new idea. Many employers have undertaken an eligibility audit to verify the dependents they are carrying indeed qualify for health coverage. While results have varied due to employee demographics, plan design, employee contributions, and how enrollment has been handled, most employers report their audit was worth the cost.

However, some recent articles have taken the position a dependent eligibility audit is contrary to building and nurturing strong employee relations. These articles advocate a "Mama Bear" perspective, saying something to the effect, "How can our employees trust us, if we don't trust them?" That rationale does not hold up in today's tough economic environment, and it reflects "old school" thinking, as leading HR executives transition their functions from parent to coach.

Findley Davies' annual health care trend survey indicates average Medical/Rx trend (i.e. changes in per capita health claims costs) for 1/1/09 renewals is 12%. What other cost of doing business, besides fuel, is increasing as fast as health benefits? Furthermore, outside of a major worksite accident or product liability issue, what exposes a self-funded organization to more risk of loss and/or budget variances than catastrophic health care claims?

You don't necessarily have to be subject to ERISA to appreciate its fiduciary responsibilities to ensure benefits are paid only to eligible beneficiaries. Similarly, you don't have to be subject to Sarbanes Oxley requirements to have strong internal auditing controls to appreciate the need to protect your organization's bottom line. There are compelling financial reasons to conduct a dependent eligibility audit, such as:

-- It is likely an audit will find 2%-13% of covered dependents are

ineligible;

-- With annual per dependent health benefit costs ave
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SOURCE Findley Davies, Inc.
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