Dallas, TX April 14, 2010 – The recently passed Patient Protection and Affordability Act (PPACA) will bring about major changes in group sponsored health plans, not least among them significantly higher costs.
It is essential to prepare and react to the coming changes quickly and decisively to help control your health plan expenses.
In this new environment, a dependent eligibility audit remains one of your best cost containment tools. “Our audit tools can help control costs associated with many aspects of this new legislation,” said HRAdvance President Craig Firestone, “but that’s especially true of Section 2712.”
This section of the PPACA prohibits the rescinding of health insurance for any reason other than `fraud’ and `intentional misrepresentation of material’. Proving that an employee has committed fraud can be extremely difficult, and will only become more challenging in the future. “A dependent eligibility audit provider who can assist in those efforts will be key to success,” states Brennan Clipp, Senior Vice President of Sales at HRAdvance.
Health Care reform should not preclude cost containment efforts
Implementing a comprehensive dependent eligibility audit process now allows companies the advantage to remove ineligible dependents before September 23, 2010, when the new standards take effect. In addition, HRAdvance suggests that employers consider:
• A Summary Plan Document (SPD) provision of who is an intended beneficiary needs to be continually monitored since, like COBRA, the regulations around eligibility will continue to evolve.
• Incorporating an affidavit process, as it relates to coordination of benefits and clarifying eligibility requirements, will protect your plan going forward for existing enrollees and new hires and their dependents.
• Implementation of an affidavit process, which clearly defines for employees what constitutes “fraud” or “intentional misrepresentation”, done in conjunction with a dependent eligibility audit clarifying for employee’s what constitutes intentional misrepresentation in Sec 2712 of the PPACA and provides employer’s with a tool to remove dependents if they are not able to evidence the relationship
Companies conducting dependent eligibility audits continue to realize immediate savings. HRAdvance clients have seen an average of 11% ineligible results from comprehensive dependent eligibility audits. To date, the company has performed more than 200 dependent eligibility audits, resulting in more than 1 million dependents audited. These efforts have saved our clients $220 million in first year savings, with an average project ROI over 1400 percent.
As the law surrounding Section 2712 of PPACA evolves, it is more important than ever for companies to sustain cost containment initiatives like dependent eligibility audits. Controlling costs while maintaining benefits for employees and their families will remain a priority for organizations that compete for talent.
HR Advance was founded in 2004 with a single mission: to provide HR and benefits professionals with best-practice hosted solutions that can be deployed without capital expenditure or IT dependency. Its guiding principle is that employees are the most valuable assets of every organization.
The company’s core competencies are its Plan-Smart™ and Plan-Guard™ dependent eligibility audit solutions. Its management competencies and healthcare focus reflect more than 150 years of combined experience in developing automated human resource, benefits, administrative and financial services for government, public and private organizations. Visit www.plansmart.com to learn more.
This press release was distributed through PR Web by Human Resources Marketer (HR Marketer: www.HRmarketer.com) on behalf of the company listed above.