Option 3: This is the same as Option 2, but involves an electronic audit of up to 100% of employees with dependents, the use of a Call Center (with extended hours available, if necessary), complete reports to the employer of audit results, and follow-up communications to the employees.
Option 4: This is the same as Option 3, but includes Findley Davies auditing the claims administrator to verify ineligible dependents were terminated in a timely and accurate manner. Any claims paid on ineligible dependents will also be tallied, so the employer can decide whether to pursue overpayment recovery. Findley Davies also provides support for this recovery process.
Senior leadership and key stakeholders will increasingly demand HR to design and execute effective strategies to control health benefits costs, so that the health benefits program remains affordable and sustainable. While it's important to cultivate trust with employees, the risk of incurring high health benefit costs on ineligible dependents must be mitigated by verifying their eligibility.
Once an employer commits to conducting a dependent eligibility audit,
finding the right audit partner becomes important. We believe Findley
Davies' TbV4 audit services offer unique advantages, such as:
-- We deliver customized pre and post-audit communications to promote
employee understanding and acceptance;
-- Our Call Center engages and educates employees about their health
plan's eligibility requirements and their responsibilities for
complying with spousal rules and/or notifying HR in the event of a
change in family status;
-- Our services are flexible and designed to leverage and compliment the
strong experience of the employer's HR staff; and
-- Updated data and practical advice is provided to strengthen and improve
|SOURCE Findley Davies, Inc.|
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