It is an understatement that COVID-19 has created a year none of us will forget, personally or professionally – and the second wave of Coronavirus has yet to peak. Renewals have been challenging for carriers, brokers, consultants, and clients because of the many utilization unknowns. Employers are currently looking at 2021 plan designs with an increased focus on telemedicine options, primary care access, and chronic care management, but they are also wary of pent-up claims.
Dependent Audit RFP volume is up over 58% in 2020 vs. 2019, and most companies are selecting their Dependent Audit vendor BEFORE Open Enrollment. This is to have help crafting language for the Open Enrollment process and include vendor information in the OE material. Announcing an upcoming DEV project during Open Enrollment leads employees to NOT enroll ineligible dependents for the new plan year. It also removes any employee surprise when the project starts, and therefore reduces noise from the employee population.
Consider this: if carrier concerns come true and employees and dependents are delaying healthcare due to COVID-19, at some point they will seek care with more acute needs. If the COVID-19 recovery happens fast, there will be a tsunami of pent-up office visits, surgeries, and associated claims. How many of those claims will be from INELIGIBLE dependents?
The uncertainty around renewals creates a need to remove risk, and one of the least disruptive ways for employers to mitigate risk, quickly, is a Dependent Audit – or Re-Audit, to ensure spouses, partners and children are eligible (or still eligible) for the coverage they will use when COVID-19 subsides. Properly executed Dependent Audits create very little noise for employers and employees but create immediate savings and removes the risk of ineligible claimants. In non-COVID-19 years, Dependent Audits can often reduce total claims by as much as 5%. Don’t let your clients be impacted by avoidable claims from ineligible dependents.