DEPENDENT ELIGIBILITY AUDITS Planning and Preparation Richard B. Chelko, President The Chelko Consulting Group and The Center for Benefits Management

Planning and Preparation  Think it through all the way before you begin.  The most successful audits begin before the verification process…  And end years after. 1

Planning and Preparation Getting Started  Review plan documents and refine or clarify language as necessary.  Review data needs and determine what it will take to support the audit process.  Complete the pre-audit decision-making process.  Determine how you will verify eligibility in the future. 2

Planning and Preparation Pre-Audit Decision Making  What kind of an audit will you conduct?  Will there be an Amnesty Period? If so, what is the incentive to participate?  What documents will be required to verify eligibility?  How much time will you provide employees?  When and how will coverage be terminated?  Will COBRA be offered?  Will there be a grace period or appeal process? 3

Planning and Preparation Eligibility Documentation  Birth certificates, birth cards, and hospital birth records?  Tax returns and alternatives to the same?  Divorce decrees and legal separations?  Documentation of joint financial responsibility?  Affidavits and notarized statements?  Full-time student verification? 4

Planning and Preparation Project Timeline 5 ActivityWeeks Planning2-3 Data Set-Up and Communication2-3 Amnesty Period3-4 Audit Period6-8 Notification/Termination2-4 Appeals Process4-8 Project Total19-30