FREQUENTLY ASKED QUESTIONS ABOUT PLAN-GUARD™

Our goal with Plan-Guard™ is simple, help our clients deploy an ongoing internal control that prevents ineligible dependent enrollment while ensuring that each participant is treated in a fair and helpful manner. If you'd like to know more about HRAdvance’s Plan-Guard solution, check out the following FAQs.

What kind of results are being realized with HRAdvance's Plan-Guard solution?

Our average Plan-Guard client finds 33% of dependent additions to the health plan fail to meet the plans’ eligibility requirements. The results range from 8% to more than 50% in high turnover retail environments.

Is it difficult to effectively outsource ongoing eligibility verification work?

Compared to a comprehensive audit, it requires more frequent data exchange. Once the correct data is being transmitted, the day to da workload is minimal. Dependent covering employees have a shorter time for employees to submit the required documentation and soon the employees mostly accept verification as part of on-boarding and life status changes. Employees increasingly understand what it means to responsibly administer the health plan.

Why HRAdvance's Plan-Guard™ ongoing eligibility solution?

HRAdvance is dedicated to providing eligibility verification services to our clients. We have tools, people, and processes in place to support your employees through the process. We believe in transparency throughout the entire project. Our proprietary technology enables you to see everything that is going on in the audit. We have project and vendor management tools in place to support the process. HRAdvance also believes that employees are your greatest asset and we have industry leading employee support throughout the entire process.

Why conduct a dependent eligibility audit?

The results of dependent eligibility verification, whether comprehensive or ongoing, indicate a compelling opportunity to enhance the internal controls utilized in benefits enrollment. Employer-sponsored health plans have emphasized convenience and expediency, relying solely on an attestation from the employees to evidence dependent relationships. Traditional enrollment processes fail to meet the needs of fiduciaries administering health plans.

Why do my people say I don't need to conduct an eligibility audit?

Healthcare costs are on the rise. Protect those employees and their eligible dependents by removing those who are ineligible. Often as not, internal resources are ill-informed and/or counter-incentivized.