When it comes to student health insurance, some universities and colleges have specific, school-sponsored plan eligibility requirements, not just for students, but for dependents as well. Let’s dive into dependent eligibility audits. Contingent upon the plan, schools may or may not be able to cover dependents.
A dependent is a person(s) relying on the policyholder (the student) for support. Dependents could fall into various categories; this person could be a spouse, parent, child (under the age of 26 per the Affordable Care Act), or even a domestic partner.
Dependent coverage is only available if the student is also insured and dependent enrollment must take place at the time of student enrollment unless there is a qualifying event such as a marriage, birth, etc.
A dependent eligibility audit is a process used by organizations to verify that all dependents enrolled in a benefit plan are eligible for coverage.
Such audits require students to provide documentation to validate the relationship between the student and the dependent. This might include a marriage license, birth certificate, tax returns or even a bank statement or adoption certificate.
If appropriate audits do not take place, an organization can lose money by covering dependents that are not eligible. Insurance companies may also incur unnecessary claims which could end up causing an increase in premiums during renewal.
We hope you would agree that verifying dependent eligibility before student enrollment begins is not only beneficial but critical. We always want to protect your students and your plans, and the best practice is verifying dependent enrollment, saving students and schools money in the long run. To learn more, visit ahpcare.com or contact us.