Carrier bills are rarely perfect the first few months after Open Enrollment (OE). If you don’t audit them, you may end up paying for terminated employees, seeing last year’s corrections misaligned again, missing retro payments, finding employees in the wrong plan tiers, or even covering over-age dependents who should have been dropped.
✦ INSIDER INSIGHT
Carrier bills should always be audited monthly. But, if you’re going to focus anywhere, don’t skip that first month after OE:
- Fully insured groups confirm tier counts and rates match your enrollment.
- Self-funded groups partner with your benefits consultant or broker to review bills alongside claims experience, runout, and eligibility. A monthly review meeting is the best way to spot trends early and keep costs under control.
WHAT GOES WRONG
- Terminated employees still billed
- New hires or elections missing
- Incorrect tier assignments
- Retro activity not applied
- Ineligible dependents left on coverage
ROOT CAUSE
- No reconciliation against OE data
- Assuming carrier invoices are accurate
- No early audit process post-OE
- Lack of ownership for bill review
HOW TO FIX IT
- Audit carrier bills monthly; don’t skip the first month after the benefits effective date
- Compare invoice counts and rates against enrollment data
- Correct errors within carrier retro windows
- Involve your benefits consultant/broker and vendor in the review
- Add bill audits to your OE closeout checklist
Want to avoid costly surprises on your carrier bills? We can help. Let’s connect.
