Insurer Enrolment Auditing gives you the ability to control costs by ensuring that all plan members and their dependents enrolled in the Group Plan are fully eligible for coverage.

Insurer Enrolment Audits may discover that there are some ineligible plan members and/or their dependents on the Group Plan because a change in age and/or status has gone unreported; however more commonly this occurs with dependents. The definition of what constitutes an eligible dependent will be determined by each individual Group Benefit Plan.

An eligible dependent may be classified as:

  • A legal or common-law spouse, including same sex partner
  • Unmarried children (including adopted, foster, step-children and legal wards) under 21 years of age
  • Children under 25 years of age if they are full-time students, not employed on a full-time basis, not eligible for insurance as an employee under this or any other group benefit program, and living with the plan member

Adminplex Resource Services Inc. can ensure that only fully eligible plan members and their dependents are able to participate in your Group Plan. Simplify the Administration of your Group Plans and avail yourself of our expertise.