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Ongoing, Year-Round Audit - Case Study

 

MEET PATTI - BENEFITS MANAGERiStock-471953302v2

KEEPING UP WITH DEPENDENT VERIFICATION IS LIKE RUNNING A MARATHON WITH A PEBBLE IN YOUR SHOE. PAINFUL!

PATTI’S STORY

Patti is the Benefits Manager of a national supermarket chain. With industry turnover at 50% annually, year-round dependent verification was a big, important task.

How did Patti handle it? First, in 2012, she conducted a full dependent audit. After that, she created an Audit Kit her field reps could use to verify added dependents.

For the next two years, her process worked well. At quarterly reviews, her field reps reported, “We are collecting documents and verifying dependents. Checkmark please!”

PENNY’S BIG SURPRISE!

On day one of our audit, Robert, a 25-year employee, completed his online affidavit, and selected his current marital status from our menu of 10 potential categories. We called Penny immediately to tell her that Robert came up “ineligible” because he had a common law spouse. There was a long silence. Then we heard her typing furiously. “OH NO!!” she gasped. “His spouse has had $243,568 in claims over the years, and we’ve never covered common law spouses!! How did we miss that?”

KEEPING UP WITH THE JONESES

Mr. Jones argued, “My daughter had a baby. They both live with me. I claim them on my taxes. So, I put them on my medical plan. I’m doing a good thing, and the right thing.”

Patti then asked her rep, “Why didn’t we catch this? “Are the rules unclear? Is the process too complicated?”

“NO,” cried the rep, “there’s nothing wrong with the process. But we have too many things to do, too many demands, all urgent. We want to do a good job, but keeping up with dependent verification is like running a marathon with a pebble in your shoe. Painful.”

To solve these problems, Patti decided (1) that she had to outsource the entire process to a third party. And (2) that the provider had to have a fail-safe system which would not allow a “Jones” situation to slip through unnoticed again. So, she hired Expert Audit.

PATTI'S EXPERIENCE WITH EXPERT AUDIT
“Our reps love Expert Audit. It eliminated their frustration, and improved their productivity. Plus, the Expert Audit online affidavit that requires an employee to tell us upfront about his/her relationships delivers the safety net I wanted. Their whole process gives us real, true peace of mind!”

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