Dependent Eligibility Verification AuditAdjust font size Decrease Font SizeIncrease Font Size

In an effort to control costs and ensure enrollment files are accurate, the Employee Insurance Program (EIP) 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 EIP. Based on these estimates, 7,500 to 15,000 potentially ineligible dependents are covered under one of EIP’s health plans.

In 2009, the average cost per dependent under the State Health Plan was more than $2,600. If only 4 percent of covered dependents turn out to be ineligible, conducting this audit will save more than $19 million a year.

  • For a list of documents required during the audit, click here.
  • Answers to common questions about the audit can be found in the Frequently Asked Questions section of the website, under "Dependent Eligibility Audit."