Our review of the files of a sample of 52 dependents, selected randomly from the 1,149 dependents enrolled in the Plan, found no evidence of any documentation showing that these dependents met any of the eligibility criteria. Of the 52 dependents tested, 13 individuals (25 percent) could not provide evidence of dependent status, and are potentially ineligible for coverage by the Plan. Participants lacked such documentation because none of the Boards have adopted policies that require verifying dependents’ eligibility before enrolling them in the Plan and procedures for monitoring eligibility status. Based on a $2,000 to $5,000 annual savings per dependent and our 25 percent exception rate, the potential savings in Trust expenses could range from $574,500 to $1,436,250 annually.
Wayne County Employee Health Care Plan Trust Participants[complete audit - pdf]