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Alight Dependent Eligibility & Compliance

Eligibility and Compliance

Save more and steer clear of risks

Our eligibility and compliance solution stops risk and spots hidden costs to your benefits plan.

We’re here to help


Health benefits plans are human. User error, forgotten forms. Our dependent eligibility and compliance solutions are easy to execute and integrate with your cloud-based benefits admin platform to stay on top of regulations you’re required to support — even as things change.

Here’s the Challenge

Benefits keep changing

Between regulations, life-changing events and a shifting workforce, it’s hard to keep costs down while reducing risk. You need to offer your people competitive benefits without costly slip ups getting in the way.

Here’s how we solve it

Stay ahead of twists and turns

Picture this: working with a partner who knows the common pitfalls of benefits administration, where to identify risks and how to proactively solve before they hit.

Spot the savings

The average dependent cost (over $4,000 a year) and healthcare costs are rising — fast. Our dependent audits find an average 5-7% of dependents ineligible in one-time audits, jumping to 10-14% in ongoing verification. The result? An average +1700% ROI on the cost of an audit.

We solve while you sleep

We’re on top of it around the clock with ongoing, and in many cases, automatic solutions, so you can carry on business as usual without risk and compliance qualms getting in the way of filing and auditing accurately. 

Spend your dollars where it counts

There’s a lot of avoidable expenses out there. Thousands to millions. Our dependent audits confirm eligibility, allowing you to reinvest healthcare dollars, in programs or premiums, that go back to your people.

One platform for the job

Say goodbye to the complicated vendor landscape. Our solution integrates on our cloud-based platform to secure data in one place, make audits seamless and allow employees to process any required forms online.

More of what’s possible with Eligibility and Compliance


Eligibility

We’ve spent years finding savings for you, auditing more than 9 million dependents from one-time audits and verifying over a million dependents each year for hundreds of our ongoing verification clients.

Benefits

  • Reduce your spend and increase net profitability
  • Demonstrate fiduciary responsibility and reduce risk
  • Deliver user-friendly experience and support
Alight Eligibility and Compliance benefits for employers

We get in the weeds, so you don’t have to. That means minimized legal risk, less admin stress and compliance that’s finally under control

Benefits

  • Support on Form 5500 administration
  • Support on POA / QDRO / QMCSO administration
  • Support processing claims and appeals
Alight Eligibility and Compliance benefits for employers

Frequently asked questions


Have a particular question about Dependent Eligibility Services? We've answered some of the most commonly asked questions.

A dependent verification audit is a process used by organizations to confirm that all dependents enrolled in a group benefit plan are eligible for coverage. Dependent verification audits require employees to provide documentation to validate the relationship between the employee and the dependent. This confirms the dependent is eligible for coverage based on the plan’s rules. Dependent verification audits are a best practice among employers and helps manage both regulatory compliance and rising health insurance costs. Dependent verification audits are predominantly used for health plan management, but can be applied to any group benefit plan that offers dependent coverage.

There is no difference between these terms – they are used interchangeably.

Employees often do not know or misunderstand the plan’s dependent eligibility rules and will unintentionally enroll ineligible dependents in the company health plan. Covering ineligible dependents costs both employers and employees significant dollars. Dependent verification protects the health plan from ineligible dependents, helping plan sponsors ensure their health plan is compliant and that benefit dollars are only being spent on participants who are eligible, keeping health care costs down for everyone.

Most plan participants who enroll an ineligible dependent are unaware of what they are doing and don’t know or understand their plan’s dependent eligibility rules. It’s rare for plan participants to intentionally enroll an ineligible dependent.

Eligibility for a group benefit plan will differ from plan to plan. However, the most common ineligible dependents on health benefit plans include: ex-spouses and ex-domestic partners, ex-step children, boyfriends and girlfriends, relatives that do not qualify as a dependent (such as parents or siblings) and personal staff (such as nannies or housekeepers).

There are two main ways to do dependent verification:

1. A one-time, comprehensive dependent eligibility audit of enrolled dependents ensures that all dependents enrolled at the end of the audit are eligible.

2. Ongoing verification for new dependents confirms eligibility of new dependents at the point of enrollment, ensuring only eligible dependents can enroll in benefits coverage. Performing a comprehensive, one-time dependent eligibility audit followed by ongoing dependent verification is the best practice.

Documentation requirements will vary, but typically acceptable documentation is a legal document that validates the dependent’s relationship to the plan participant. For example, for a biological child, the child’s birth certificate, listing the child’s name and date of birth and listing the employee as the parent, is acceptable.

Customer story


Realizing huge savings for Brinker with Dependent Verification Services

“Brinker’s partnership with Alight’s Dependent Verification Services has been a huge win for us, going above and beyond in their interactions with our team members and for having such a huge impact on our plan costs.”

Lara Kent, Senior Benefits Manager, Brinker International

Handling rising healthcare costs with Dependent Verification at University of Arkansas

“How we maintain competitive benefits that are affordable for the university is always top of mind. We have to take care of our employees, but how do we do that in the most cost-efficient way?”

Steve Wood, Associate Vice President for Benefits and Risk Management, University of Arkansas System

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