Tuesday, April 17, 2012

Draft Employee Dependent Eligibility Audit Released

During Christmas break last year I received a letter from the District’s Risk Management Department asking for proof that my children and wife were/are eligible for the benefits for which they are enrolled. I gathered the requested documents and sent them it to the auditor within a week. Birth Certificates, Marriage License, and all of the requested paperwork—sent in. I was happy to comply with this request once I spoke to our Audit chief, David Bryant, and learned that EVERY employee with dependents enrolled in our plan had to comply and send this paperwork in for verification.



The goal was to ensure that every enrolled dependent was actually eligible—and that those that are/were not eligible would be removed. This process appealed to me because it will ensure efficiency with taxpayer resources that are utilized to fund our self-insured health benefits.


My only concern was that everyone be treated equally and that everyone be held to the same timelines for sending in the paperwork. I was assured by David Bryant and also by Kevin Windham from Risk Management that this was going to be the case.


I am now in receipt of



the Audit team’s draft report—and it appears that everyone has responded, with the exception of a very small number of employees, representing only 1.07% of the total sample group.


Highlights from the report:


--Dependents from a total of 1,396 employees were tested for eligibility.


--During the audit, 43 dependents from 33 employees were removed from coverage.


--15 Employees failed to provided the requested verification documents for their dependents, and these employee files are turned over to the Risk Management Department for further action, which may include termination of coverage for those dependents not verified


--Eligibility determinations were made for 2,612 dependents from 1,348 employees, representing 95.67% of the sample size.

 
Some of the local fringe media types had blogged and posted different characterizations about this audit, framing it as some sort of a massive invasion of privacy—instead of following up on the issue and getting the real facts from those who know—as a professional journalist with integrity would have done. As is very common with this one local alternative progressive weekly and the posters to his blog, though, these sorts of ominous speculative characterizations are simply wrong.


The actual impetus for the audit was to save taxpayer resources and eliminate any improper use of these funds.


Of course we’ll get no credit for this, but that’s okay.

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