Ongoing Audits… Are They Worth It?

Are ongoing audits worth it? If you are interested in continually containing your healthcare costs each year, the answer is a big yes. Conducting Ongoing Dependent Eligibility Auditing for new hires and those with qualifying event changes protects the integrity of your benefit plans and the original, comprehensive audit, while ensuring you’re only paying for eligible dependents on your plan.

While no employer wants to believe their employees would knowingly add on ineligible dependents year after year, think about the cost not completing an ongoing audit.

The average cost of treating America’s number one killer—a heart attack—can range from $9,000 to $50,000 depending on your region. Now imagine a few dozen of your employees’ ineligible dependents having this care done while on your plan.

Without the ongoing audit, you could be paying millions in health benefits for people who should not be on your plan, negating the savings you realized from your original Dependent Eligibility Verification audit. If that’s not scary enough, just think about a stop loss claim being denied on a catastrophic loss because the stop loss carried determined the dependent was ineligible for your plan.

Participating in ongoing audits is beneficial and allows your company to continually manage rising benefit costs.