The Process

Capitol Celebrates over 20 Years as Leaders in Providing Insurance Coverage

Each client is different and has different goals, and thus the dependent eligibility verification process will need to be tailored to your company. The standard process is as follows:

• Planning Phase – During this phase we will define your goals, and work to develop timelines and business rules on how the audit will be conducted to accomplish your objectives. This is a critical phase, and important to ensure a positive employee experience and meet client expectations. At this time, we will design and obtain approval on all letters to be received, and also set up an employee help line to allow for employee questions.

• Amnesty Phase – This is the step in the process which allows ineligible dependents to be removed from the plan, normally without any repercussions to the employee. Your employees will receive communication with clear instructions on the process. Finally, we work hard to make the process easy for employees and support the process with friendly, experienced staff to answer their questions.

• Verification Phase – The employee is then required to provide documentation that shows their enrolled dependents as meeting the true definitions of eligibility under your plans. This is done by submitting appropriate documents to validate their eligibility, based upon the requirements set out in the planning phase.

• Reporting – Periodically throughout the auditing process, you will be given timely reporting to show progress on how the dependent eligibility verification is moving forward.

Our staff is comprised of individuals highly experienced in the employee benefits field, so you can rest assured we understand the needs of your company in needing to show the return on investment for your efforts.

In simpler times, intact families made eligibility easy. However in today's society, it has become difficult to even determine who is a covered dependent.