Eligibility Audits for Health Plans (including Health FSAs and HRAs)

Protect Your Plans From Covering Ineligibles

Available immediately

In a recent survey, 60 percent of employers said they were auditing or reviewing health plan eligibility. Not only can an eligibility audit help create significant cost savings, it can also lead to improved enrollment processes going forward. In this 90-minute web seminar, our experts help employers, advisors, and service providers in evaluating the pros and cons of eligibility audits, understanding the logistic and legal issues presented, and planning the most effective audit for their health plans.

Originally presented on October 22, 2009.

Seminar Level


Intermediate Difficulty

Topics Covered

Here’s some of what was covered:

  • What are the mechanics of a typical eligibility audit? Can eligibility audits be scaled to employer size and budget restrictions? Should audits be done in-house or with outside assistance?
  • How do you make sure employees and benefits personnel understand who is eligible and who isn’t? What should you do if plan documents and SPDs do not contain clear and consistent eligibility provisions?
  • What should you communicate to employees about eligibility audits? Should you allow an amnesty period for voluntary disenrollment of ineligibles?
  • Who should be audited and what special issues are presented by particular groups (e.g., spouses, dependent children, domestic partners)? What proof should employees be required to submit regarding dependent eligibility? Should health FSAs and HRAs require enrollment of family members?
  • What other legal issues might arise from an eligibility audit (e.g., must COBRA be offered to ineligibles dropped from coverage)?

Details

Speakers: Darcy L. Hitesman and Brigid Carroll Anderson. Ms. Hitesman is an attorney and principal shareholder of Hitesman & Associates, P.A., in Minneapolis. She is a Contributing Author of EBIA’s ERISA Compliance for Health & Welfare Plans manual. Ms. Anderson is an attorney, Director of Seminars at EBIA, and a Contributing Author of EBIA’s ERISA Compliance for Health & Welfare Plans manual.

Handouts: A handout of the seminar slides and other information is provided through download.

Viewing Details

Accessing the recorded web seminar: After you purchase a recorded web seminar, you will receive an email with access information. You and your co-workers may then view the recording as many times as you wish for 60 days. An internet connection is required to view the recording; it can be stopped and started as needed and has a table of contents for easy navigation.

Recordings are accurate as of the date presented: Our recordings are accurate as of the presentation date of the live seminar. We supplement handout materials with articles from the EBIA Weekly covering significant later developments. You must check the table of contents at your access link for updates before viewing a recorded seminar.

Please respect our copyright: Do not record the web seminar, share the access link, or duplicate materials. For details on our copyright policy, please visit our Copyright page.

System Requirements for Recorded Web Seminars

EBIA uses WebEx technology for the seminar. You may wish to view system requirements, test your system and download any necessary WebEx software here:

http://www.webex.com/lp/jointest/

If you are not able to complete the WebEx installation, please contact WebEx technical support at (866) 863-3904.