Download your Dependent Eligibility Audit Evaluation Resource by clicking on any of the following bullets:

• Download the full Dependent Evaluation Resources Kit

Individual PDFs:

• Vendor Qualifications for Dependent Eligibility Audit
• Evaluating Dependent Eligibility Audit
• Building the Business Case
• Comprehensive Dependent Eligibility Audit
• Most Common Dependent Eligibility Audit Mistakes

View Dependent Eligibility Audit results by industry.

Do you have effective quality controls for your health plan(s) dependent eligibility? 

Health plan enrollment has lacked any meaningful Internal Controls for decades. For instance, enrollment forms have not changed much since the 70s. Moving enrollment to the Web simply compounds the problem. This outdated process was designed to facilitate gaining coverage through an employee signature, but paper and web forms fails to verify the eligibility of dependents.  

The fact is that most providers don’t have the infrastructure, systems, or incentives to ensure quality control.

In order to have effective controls you need:

1. A comprehensive evidence based verification process; and
2. A Gate Keeper solution that takes ongoing events such as hires, fires, promotions, weddings, divorces, COBRA, etc. into account and manages eligible dependents.