RFI: Dependent Eligibility and Verification Audit
The State wishes to hire a qualified auditor for a complete audit and evaluation of the eligibility of dependents claimed on Benefit Plans. State agencies are located throughout the State. The proposed audit should ensure that dependents claimed on the health, dental, and vision plans meet the guidelines outlined in Summary Scope of Work section.
SUMMARY SCOPE OF WORK
The scope of this eligibility audit should include membership records from the health, dental, and vision plans for the time period beginning with the next plan year starting on January 1, 2010. The review should be constructed in a fashion that will allow the auditor to determine if dependents claimed meet the criteria below. It is intended that the Contractor perform a 100% audit of dependents covered by the plans. The State wishes to obtain services of a Vendor that can provide the following services:
Provide assistance to the State regarding methods to notify employees of an upcoming audit.
Audit the State employees dependent population for compliance with the State definition of eligibility.
Recommend cost savings opportunities as a result of a dependent eligibility audit.
Identify possible recovery procedures to the State.
Provide comprehensive reporting on the audit results and recommendations.
