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Combined Savings: Audit of Dependent Eligibility & Spousal Surcharge

Business Situation & Client Profile:  

A small employer group with 259 employees covering 600 dependents contacted BMI to: 1) verify the eligibility of all dependents and 2) determine whether or not enrolled spouses should be paying a spousal surcharge per the plan.

Solution:

BMI customized an audit plan to meet …

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Dependent Verification Saves Group Over 2 Million

Business Situation & Client Profile:  

This city and county government approached BMI to help confirm if health care plan dollars were being spent appropriately by verifying the eligibility of 7,596 enrolled dependents.

 

Solution:

BMI customized a dependent eligibility verification plan to meet the following goals:

  • Communicate the purpose of
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Dependent Verification Equates to Real Savings

Business Situation & Client Profile:  

To ease the burden of rising health care costs and reduce risk, this manufacturer enlisted BMI’s assistance with dependent verification of  1,020 enrolled dependents on the health plan.

 

Solution:

BMI customized a dependent eligibility audit plan to meet the following goals:

  • Communicate the purpose
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Savings Follow Verification of Spousal Eligibility

Business Situation & Client Profile:  

To ease the burden of rising health care costs, this manufacturer enlisted BMI’s assistance to verify if 344 enrolled spouses were eligible under their employer’s health plan and therefore ineligible on the manufacturer’s plan. The employer also elected to verify the eligibility of 623 dependent …

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Claims Audits – An Immediate and Future Cost Reduction Strategy

Business Situation 

This county government client approached BMI to conduct an audit of medical and prescription drug claims for cost reduction purposes after a significant rise in insurance expenditures.

 

Solution

Utilizing our experienced staff and proprietary AUDiT iQ™ software, BMI set the following objectives:

  • Analyze 100% of all medical
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Audit of Dependent and Spousal Surcharge Eligibility Achieve Combined Savings

Business Situation & Client Profile:  

A regional hospital and healthcare center with 650 employees covering 1,480 dependents contacted BMI to: 1) verify the eligibility of all dependents and 2) determine whether or not enrolled spouses should be paying a spousal surcharge per the plan. Verification was previously performed internally.

 

Solution:

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Savings Continue Following Annual Dependent Eligibility Audit

Business Situation & Client Profile:       

This manufacturing client contacted BMI to conduct an annual dependent eligibility audit of all 2,361 enrolled dependents due to high turnover and limited resources to verify eligibility for new hires. Their last audit with BMI resulted in over $450,000 in annual savings.

 Solution:

BMI customized …

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Value Realized – Periodic Dependent Verification Still Successful

Business Situation & Client Profile:       

A regional healthcare system asked BMI to verify the eligibility of all 5,143 dependents enrolled in their health plans after several years had passed since their last dependent eligibility audit.

 

Solution:

BMI customized an audit plan to meet the following objectives:

  • Communicate the purpose of
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Client Achieves a 1,200% Return of Investment Ratio

This time of year is ideal for any employers considering a dependent eligibility audit.  Any intentions to audit can be communicated to employees during open enrollment with an audit shortly following after enrollment closes.

Business Situation:
A large diversified worldwide specialty metals producer came to BMI regarding their needs for

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