Dependent Eligibility Verification
This is an advanced verification process that validates the healthcare eligibility of each employee’s dependents. On average we find that 3-8% of dependents on health insurance plans are ineligible for coverage. The estimated annual cost per dependent when factoring in premiums, administrative costs, and claims exceeds $4,000. Any significant claim incurred by an ineligible dependent will negatively impact the bottom line of a business, whether full-insured or self-insured. Employees may be negatively impacted as well through premium increases passed on to them at renewal by the health carrier.
Business Example:
- Self-Insured Plan with 25 ineligible dependents at $4,000 in annual cost
- Company has 5% Profit Margin
- Company would have to generate $2,000,000 in sales to cover the ineligible dependents on the plan