Cook County Dependent Verification Program to Provide Savings, Reduce Fraud
Cook County Board President Toni Preckwinkle announced today that a comprehensive dependent eligibility verification program conducted by the County's Department of Risk Management could result in as much as $12.5 million in savings through the elimination of coverage for ineligible dependents.
As the cost of health care increases, Cook County has been continuously working to manage the benefits offered to employees and their families in a manner that is fair and responsible. Risk Management partnered with HMS Employer Solutions, an independent third-party audit company, to perform the review.
This program allows the County to verify that all dependents enrolled for coverage are actually eligible and that taxpayers are not incurring unnecessary costs, Preckwinkle said. Whether through accidental oversight or deliberate action, it is important that we make sure we are not paying for ineligible dependents. This is another important best practices initiative that saves taxpayer dollars and promotes increased accountability.
Over the course of the program, which allowed employees nearly two months to respond, more than 91 percent of the 32,000 dependents enrolled in the County's health plans were certified. The audit allows the County to confirm that all of the dependents enrolled for coverage are indeed eligible based on the County's plan requirements. Benefits for dependents were eliminated in cases where eligibility guidelines were not met or appropriate documentation to verify eligibility was not submitted.
In early June, employees with dependent coverage received a letter explaining the process, with additional outreach occurring over the course of the program. In total, nearly 43,000 communications were sent to County employees via email and letter from HMS Employer Solutions.
The program ensures that both the County and its employees are not paying higher costs because of dependents that should not be covered under the plan. Dependent benefits under the County's health, pharmacy, dental and vision plans are extended to spouses, domestic and civil union partners, and children (natural, adopted, step or under legal guardianship) up to age 26. Military veterans may be covered up to the age of 30. In an effort to continue to manage plan resources effectively, Cook County will continue to verify newly enrolled dependents as well.
If you are ineligible to be a dependent, the County should not be providing your health coverage, Preckwinkle added. Cook County is facing a challenging budget year and we must continue identifying creative ways to find savings. The Dependent Eligibility Verification Program will help us continue doing that by ensuring that all dependents enrolled in our plans meet eligibility guidelines.