What the heck is a Dependent Audit? A dependent audit, or a dependent eligibility audit, is something a self-funded employer does to ensure the dependents enrolled on a health plan are actually eligible to have medical coverage.
2:04 - Podcast Start
Keith Bird, VP of Sales for AmWINS came on the Self-Funded with Spencer Podcast to discuss the fiduciary responsibility that Self-Funded Employers have to make sure their employees are not enrolling ineligible dependents, whether intentionally or unintentionally, onto an employer-sponsored health plan.
Unless you have a good way of validating the eligibility of enrollees manually (you probably don't) then you likely have dependents on your plan today that are not supposed to be there. Keith estimates that about 3% of dependents on average on any given plan are not eligible.
Whether it is a person enrolled as a spouse when they actually aren't married, or an enrolled child on the plan that turns out to be a cousin, the cost of healthcare is so great that many people find the need to defraud their employers for coverage.
