Why the Actual Verification of Other Coverage is Critical

You adopted Working Spouse Rules, but you aren’t seeing significant cost savings? Blame it on the honor system. Employers using employee affidavits to check for the availability of other coverage are losing out on nearly two-thirds of their healthcare cost savings.

Other Coverage Verification is critical when it comes to Working Spouse Provisions. Many employers choose the poll and sign method (honor system). While this method is popular, it’s not accurate. In fact, 30% of the spouses who claim they don’t have coverage actually do.

No employer wants to believe their employees are being untruthful, but just as your healthcare costs are rising, so are theirs. Employees have a number of reasons for completing the affidavit inaccurately:

• Want to keep the whole family on the same plan
• Unaware of the spouse’s coverage
• Spousal coverage costs might be better under your plan
• The spouse may be incentivized by their employer to deny coverage by their plan

The ConSova approach to Other Coverage Verification is a tried and true method—we contact the spouses’ employers directly to confirm the absence or existence of health benefits. This more accurate method ensures you are realizing maximum healthcare cost savings when it comes to Working Spouse Rules.