Alight
Health Solutions

Dependent Verification Services

Our eligibility and compliance solution stops risk and spots hidden costs to your benefits plan.

We’re here to help

As health care costs continue to rise, it’s more challenging than ever to provide the competitive benefits your people want while keeping your spend under control.

Each year, many organizations lose thousands, if not millions of dollars by covering dependents that are not eligible for their company-sponsored health plans. With our Dependent Verification Services, you can prevent this loss, ensure that only eligible dependents are covered, and stay compliant.

The challenge

Benefits keep changing

Between regulations, life-changing events and a shifting workforce, it’s hard to keep costs down while reducing risk. You need to offer your people competitive benefits without costly slip-ups getting in the way.

The solution

Stay ahead of twists and turns

Picture this: Working with a partner who knows the common pitfalls of benefits administration, where to identify risks and how to proactively solve before they hit.

Help your people get more from their benefits. And watch your bottom line grow.

Frequently asked questions

Have a particular question about Dependent Verification Services? We've answered some of the most commonly asked questions.

A dependent eligibility audit is a process used by organizations to verify that all dependents enrolled in a group benefit plan are eligible for coverage. Dependent eligibility audits require employees to provide documentation to validate the relationship between the employee and the dependent. This confirms the dependent is eligible for coverage based on the plan’s rules. Dependent eligibility audits are a best practice among employers and helps manage both regulatory compliance and rising health insurance costs. Dependent eligibility audits are predominantly used for health plan management, but can be applied to any group benefit plan that offers dependent coverage.

Employees often do not know or misunderstand the plan’s dependent eligibility rules and will unintentionally enroll ineligible dependents in the company health plan. Covering ineligible dependents costs both employers and employees significant dollars. Dependent eligibility verification protects the health plan from ineligible dependents, helping plan sponsors ensure their health plan is compliant and that benefit dollars are only being spent on participants who are eligible, keeping health care costs down for everyone.

Outsourcing liberates internal resources from transactional activities related to benefits, including open enrollment, verifying dependents, processing life event changes and answering health benefits and other questions. Having an outside expert administer your benefits reduces the expenses associated with manual errors and premium overpayments.

Most plan participants who enroll an ineligible dependent are unaware of what they are doing and don’t know or understand their plan’s dependent eligibility rules. It’s rare for plan participants to intentionally enroll an ineligible dependent.

Eligibility for a group benefit plan will differ from plan to plan. However, the most common ineligible dependents on health benefit plans include: ex-spouses and ex-domestic partners, ex-step children, boyfriends and girlfriends, relatives that do not qualify as a dependent (such as parents or siblings) and personal staff (such as nannies or housekeepers).

There are two main ways to do dependent eligibility verification:

  1. A one-time, comprehensive dependent eligibility audit of enrolled dependents ensures that all dependents enrolled at the end of the audit are eligible.
  2. Ongoing verification for new dependents confirms eligibility of new dependents at the point of enrollment, ensuring only eligible dependents can enroll in benefits coverage.

Performing a comprehensive, one-time dependent eligibility audit followed by ongoing dependent verification is the best practice.

Documentation requirements will vary, but typically acceptable documentation is a legal document that validates the dependent’s relationship to the plan participant. For example, for a biological child, the child’s birth certificate, listing the child’s name and date of birth and listing the employee as the parent, is acceptable.

More of what’s possible with Eligibility and Compliance

We’ve spent years finding savings for you, auditing more than 9 million dependents from one-time audits and verifying over a million dependents each year for hundreds of our ongoing verification clients.

Benefits

  • Reduce your spend and increase net profitability
  • Demonstrate fiduciary responsibility and reduce risk
  • Deliver user-friendly experience and support

We get in the weeds, so you don’t have to. That means minimized legal risk, less admin stress and compliance that’s finally under control.

Benefits

  • Support on Form 5500 administration
  • Support on POA / QDRO / QMCSO administration
  • Support processing claims and appeals

“Alight is constantly evolving to keep up with changing laws and new technology and our Client Manager, Melissa, is top notch. The employer web portal is fantastic and allows us to answer questions from team members and research past verifications. Alight’s Dependent Verification Services won our coveted Supplier of the Year Award for going above and beyond in their interactions with our team members and for having such a huge impact on our plan costs.”

Lara Kent, Senior Benefits Manager
Brinker International