National Other Party Liability Group (NOPLG) 2012

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May 1- May 4, 2012, San Antonio, Texas

Presentation: Exploring the Business Case for Health Plan-directed Dependent Eligibility Audits

Speaker: Paul Vosters, President & COO, Discovery Health Partners

Thursday, May 3, 1:15-2:30 p.m.

Rising health insurance premiums. Higher divorce rates. Blended families.  What do they share in common?  All are reasons why more health plan clients are verifying who among their employees and dependents are rightful benefits holders.

In recent years, dependent eligibility audits have shot up in prevalence in an attempt to control the rising expense of health insurance. Now there’s a new wrinkle in the mix: the Affordable Care Act, passed in 2010, which requires group health plans to continue making coverage available for children until the age of 26 regardless of marital status.

With additional dependents now eligible for coverage, the business case for dependent eligibility verification is stronger than ever. On average, employers find at least 3% to 6% of their covered dependents are ineligible for health benefits – a financial burden that can be quickly and significantly reduced with periodic dependent eligibility verification.

An unrealized opportunity exists for health plans to offer dependent eligibility services to their ASO and fully insured clients in an effort to control premiums and deliver greater customer value. This session explores the business case for health plan-directed dependent eligibility verification as a part of a customer-centric and holistic healthcare cost containment strategy.  What roadblocks should health plans expect by developing this new service?  What ROI and other benefits can be derived?  Learn about the rewards that dependent eligibility can offer health plans and their customers and ways to navigate potential obstacles.

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