In an effort to control costs and ensure enrollment files are accurate, PEBA Insurance Benefits is conducting a dependent eligibility verification audit. Dependent eligibility verification audits have been used by Fortune 500 companies for more than a decade.
According to most experts, 4 to 8 percent of the dependents covered under an employer-sponsored plan are ineligible for coverage. These dependents are often divorced spouses, grandchildren or other family members who are not eligible for benefits.
About 187,000 dependents have health coverage through PEBA Insurance Benefits. Based on these estimates, 7,500 to 15,000 potentially ineligible dependents are covered under one of PEBA Insurance Benefits' health plans.
In 2012, the average cost per dependent under the State Health Plan was more than $3,100. If only 4 percent of covered dependents turn out to be ineligible, conducting this audit will save more than $23 million a year.