By Katherine Reynolds Lewis
Houston Chronicle
January 12, 2008
Meet the insurance audit. Increasing numbers of employers are requesting personal documents to ensure that all the dependents in their health care plans are entitled to coverage.
With insurance costs rising faster than inflation for a decade, they want to verify that you’re actually married to the person receiving spousal benefits, or that your 19-year-old son really is enrolled as a full-time student. If you can’t produce proof, the dependent loses coverage.
“There has been a significant growth of interest in conducting these types of reviews,” said Daniel Priga, a Pittsburgh-based principal for the Mercer workplace consulting firm, where the workload conducting audits has doubled in each of the past two years. “This is a hot one.”
“The high turnover industries are the most likely to do them: service, retail, banking,” adds Susan Johnson, a senior consultant with Watson Wyatt Worldwide in Chicago. “Everybody’s at least talking about them. It’s grown exponentially in the last 18 months.”
An employer’s savings quickly dwarfs the expense of conducting an audit, as each dependent costs an average $3,000 a year to cover, said Michael Watson, a senior vice president for Budco.
http://www.chron.com/disp/story.mpl/headline/biz/5448912.html
Comment:
By Don McCanne, MD
Under our current system of financing health care, it certainly seems only fair that an employer who is generous enough to offer dependent coverage (even if nudged by union negotiators) should not be expected to cover additional relatives or friends of employees if those individuals are not eligible dependents.
But step back and look at the problem phrase in that sentence: “Under our current system of financing health care…”
Under our current system, which is already weighted down with administrative excesses, yet more wasteful administrative services are being provided in order to achieve the exact opposite of one of the most important goals of health care reform. These administrative services are being provided for the purpose of reducing the numbers of individuals with health care coverage. We really do need to change to a health care financing system in which absolutely everyone automatically receives comprehensive, affordable coverage for life.
As the consultant from Mercer said, “This is a hot one.” Yes… for the administrators. But not for those who lose their coverage.
