dependent-eligibility-audit

  • Conduct an amnesty-style audit.
  • Get buy-off from stakeholders, unions and other decision makers before conducting the DEA.
  • Introduce third party vendor to everyone involved in the audit so they understand with whom they will be working (if you hire a vendor to manage the process).
  • Keep all messaging about the audit positive to employees.
  • Have clear communication about the audit, process and deadlines.
    • Send initial communication to employees prior to the DEA start announcing the audit
    • Communicate the “Who” – Be clear about who is not eligible for health plans
    • Communicate the “What” – Explain what a DEA is
    • Communicate the “Where” – How employees will provide documentation
    • Communicate the “When” – Clear deadlines and timelines
    • Communicate the “Why” – Tell employees why you are conducting the audit
  • Review plan documentation to determine eligibility.
  • Determine employer specific documentation required from employees.
  • Determine employee incentives for complying with the audit.
  • Determine employee consequences for not complying with the audit.
  • Conduct the same audit for all employee groups within your organization. Treat everyone the same.
  • Draft documentation letters to be mailed to employees for completion.
  • Mail approved documentation letters.
  • Have a team to assist employees with questions, concerns and reminders that documentation is due.
  • Collect and track dependent verification information.
  • Hold records on a secure and HIPAA-compliant record keeping and database system.
  • Alert employees that they’ve complete the process.
  • Stick to the deadlines; do not extend deadlines for employees who have not submitted documentation.
  • Alert employees who have dependents that will no longer be covered.
How to Conduct a Successful Dependent Eligibility Audit (DEA) Checklist

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