Dependent Eligibility "Gnashing" Forecasted

September 11, 2007

Experts predict the upcoming open-enrollment season will be rife with teeth-gnashing from employees and their dependents. The Wall Street Journal reports more and more employers are turning to audits to ensure dependents meet plan coverage criteria. Watson Wyatt says over the past year and a half, employer interest in audits has increased five-fold. The number of actual audits has doubled, according to Susan Johns, a consultant for the international firm.

It is estimated that between 2% and 40% of plan dependents don’t meet eligibility requirements. WSJ points to HR and benefits-firm Secova’s assessment that 10% of dependents in an average health plan are ineligible. Add it all up with rising costs and employers are more likely to ask for substantiation documents when vetting dependents.

That means workers may need to dig out their marriage and birth certificates, proof of college enrollment for student dependents, and any other document that could be needed or used to prove a dependent relationship.