Posts Tagged ‘Dependent Verification Audits’

Conduct an in-house audit or choose a vendor?

Posted on: June 29th, 2011 by hmshealthcare

So, you need to meet compliance obligations, ERISA and SOX, and you know a dependent audit is the “right thing” to do but how do you get started?  After realizing the need to conduct a dependent eligibility audit, any organization will need to determine if they have the resources to perform the audit internally or […]


Dependent Audit Saves Schools Millions

Posted on: June 1st, 2011 by hmshealthcare

HMS Employer Solutions administered a dependent verification audit on behalf of the Non Monroe County Municipal School District Program (NMCMSDP), a consortium responsible for providing benefit coverage for employees and retirees across 38 separate school districts in New York.  The final result of the program was an estimated cost savings (based on claim analysis) of […]


Q&A: Random Sample Dependent Eligibility Audits (Part I)

Posted on: May 9th, 2011 by hmshealthcare

QUESTION: What is the best practice regarding how a random sample dependent eligibility audit would be conducted? As an employer, it is important to ensure you are going through the process of identifying the right approach for your dependent eligibility audit. Roughly 2-3% of our clients choose a random sample audit over a 100% audit. […]


Employer Reality: A Study on Health Care in 2011

Posted on: March 24th, 2011 by hmshealthcare

Employers, HR, and Benefits personnel have been working diligently to implement plan design changes based on mandates in Health Care Reform. Yet, even with all of those efforts employers’ health care costs are expected to increase by 7% in 2011 according to research by the National Business Group on Health and Towers Watson. The study […]


Security & Privacy Considerations When Conducting a Dependent Eligibility Audit

Posted on: March 17th, 2011 by hmshealthcare

If you are planning to conduct a dependent eligibility audit on your own, there are many things to consider.  Below is a list of items related to security & privacy that you should think through. When your employees send you verification documents, are you going to retain them?  If so, they’ll need to be in […]


Dependent Audit Moves County Budget from Negative to Positive

Posted on: October 5th, 2010 by hmshealthcare

Many public entities are enduring tremendous financial pressures which have forced them to reduce expenses. With the rise of healthcare costs, these entities have begun searching for fast and proven ways to cut costs while still maintaining health coverage for employees and their eligible dependents.  Increasingly, these entities are choosing Dependent Eligibility Audits to help […]


Proposed HHS Rules Regarding What is Required to Maintain a Plan’s Grandfathered Status

Posted on: June 14th, 2010 by hmshealthcare

Our previous white paper on dependent eligibility under health care reform highlighted the importance of maintaining your plan’s grandfathered status in order to reduce the cost-impact of the Patient Protection and Affordable Care Act (PPACA). HMS has access to a copy of the proposed rules regarding how plans can maintain their grandfathered status. You can […]


3 Dependent Audit Questions Regarding the HHS Guidance on Dependent Coverage

Posted on: May 13th, 2010 by hmshealthcare

Now that HHS has provided a first round of guidance for the implementation of the dependent coverage provisions of Health Care Reform, new questions emerge. Question #1:  Do the changes negatively impact the expected results of a dependent audit? The short answer is “yes,” but it is important to consider the size of the impact […]


HHS Issues Interim Final Regulations on Dependent Eligibility Definition Under Health Care Reform

Posted on: May 10th, 2010 by hmshealthcare

The Department of Health and Human Services(HHS) issued interim final rules regarding how dependent eligibility can be defined under health care reform. The rules (excerpted and linked below) reinforce how critical it is to maintain the grandfathered status of a group health plan. See our white paper for a complete overview of the strategies that can be used to reduce the financial impact of health care reform on dependent eligibility. Employers should begin planning right away to implement an affidavit process to determine if adult dependents have access to health coverage as a result of their own employment. Contact us to find out more about how this process would work.


Dependent Eligibility Under Health Care Reform: Cost-Containment Strategies for Employers

Posted on: April 8th, 2010 by hmshealthcare

HMS has just released the first white paper regarding how health care reform will impact dependent eligibility for group health plans. Dependent Eligibility Under Health Care Reform: Cost-Containment Strategies Employers Should Take From The Signing Of The Bill to Beyond 2014 The impact of the Patient Protection and Affordable Care Act (PPACA) and The Health […]