Dependent Eligibility

Ensuring the eligibility of all dependents enrolled in an employer-sponsored health plan is crucial to reducing financial, legal and employee risk. As health care inflation continues to place a burden on all Americans, much emphasis has been placed on employers and their ability to administer their Health Plan effectively as well as their commitment to ensuring that plan assets are being used appropriately. Since health care is the fastest growing line item on most plan sponsor’s income statements, more and more organizations are also looking for a way to quickly reduce their spending in this area.

As part of our commitment to deliver meaningful solutions, CLVL Solutions has partnered with an Atlanta-based firm to provide Dependent Eligibility Management services that deliver guaranteed cost savings and maximum compliance, with minimal operational disruption - all within a short 14 week timeframe. Dependent Eligibility Verification projects can be conducted in tandem with open enrollment or off-cycle and Ongoing Eligibility Management Solutions are available to keep the Health Plan “clean” after all dependents are verified.

The unique employee-centric approach, robust patent-pending verification technology with built in Health Insurance Outplacement Counseling for those found ineligible, and highly experienced dedicated project professionals make up the key components of this offering. Our goal is to provide a solution that not only focuses on helping the employees complete the process by emphasizing education every step of the way, but also empowers the HR team through defensible and consistent real-time information and the confidence that their project will be completed on deadline with the industry’s highest response rate (97%).

Fees can be arranged on a Shared Savings or a Fixed Fee basis and the savings are guaranteed.

CLVL Solutions clients can expect:
– 3 – 12% Ineligible dependents discovered
– Overall health plan expense reduced by 3 – 5%
– 3:1 Return on investment guaranteed
– Project completed within 14 weeks
– Ongoing procedures for continued savings recommended

Download the Continuous Health, Hospital Result in Acrobat PDF format.