A comprehensive evaluation is an independent certification or re-certification of the eligibility status of 100 percent of the enrolled dependents in your health plan. It is the most extensive and exhaustive dependent verification service available.
In a comprehensive evaluation, our trained consultants will contact each employee with enrolled dependents in your health plan to obtain the agreed-upon documentation that is necessary to validate the eligibility of each dependent based on plan guidelines. As the participants provide us with documentation, our consultants will review the support to determine its adequacy and compliance with plan requirements. We will work with participants who provide inadequate or noncompliant support in an attempt to minimize the number of participants whose documentation is incomplete.
This evaluation often involves an amnesty period, during which an employee may remove a dependent from the plan without consequence. Ineligible dependents are generally removed from the plan immediately. The ineligible dependents may be reinstated once, and if, the proper documentation is provided.
The level of detail required for an employee to certify a dependent makes this service more effective than the affidavit evaluation approach and yields the greatest savings to the plan.