How to Prepare for a Dependent Verification Review

Category: General

As part of your annual benefits enrollment, your employer may schedule a Dependent Verification Review. This process will verify whether your dependents are eligible for coverage under the rules of your medical, dental, vision, and/or other benefit plan coverage.

These reviews are typically completed every three years, but some employers may wish to update this information annually. This review also helps your employer have the information ready to report on when tax season arrives and when Patient Protection and Affordable Care Act reports are due.

A Dependent Verification Review Reduces Your Risk

If a claim for an ineligible dependent is discovered, you may be required to repay either your employer or healthcare provider for that dependent’s coverage. Which means there’s the risk of bearing the total cost of healthcare claims by that dependent. By removing ineligible dependents before you enroll them, you can help to avoid this issue.

Who is an Ineligible Dependent?

Your different plans may have different eligibility rules. But, the most common ineligible dependents include:

  • children over the age of 26
  • ex-spouses
  • ex-stepchildren
  • other relatives not your spouse or children (like parents or siblings)

What to Expect in a Dependent Verification Review

Your employer should let you know before enrollment that you’ll have a Dependent Verification Review as part of enrollment. They should also provide a list of the documents you’ll need to bring with you to validate your relationship with the dependents enrolled in your benefits. Typical documents you may need to bring may include:

  • tax documents
  • proof of residence
  • marriage license
  • birth certificates
  • adoption paperwork

During your one-on-one benefits review, your verification documents will be inspected. You should learn right away if your dependents are qualified and if you’ve provided the correct information. At the end of the review, you’ll get a signed Dependent Eligibility Form.

 

This blog is up to date as of November 2020 and has not been updated for changes in the law, administration or current events.

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