After facing rising healthcare costs year after year, a large HVAC/R supplies distributor leveraged their partnership with SISCO, our in-house claims management TPA, to implement a strategic solution that would significantly reduce their healthcare spending without compromising employee benefits.
The company already had a spousal carveout policy in place to manage costs, but suspected there might be room for improvement. Rather than implementing more restrictive policies or shifting costs to employees, they worked with their trusted claims management partner, SISCO, to conduct a comprehensive spousal eligibility audit - a decision that would prove to be tremendously valuable.
Through this straightforward audit process, which required minimal involvement from the company's HR department, SISCO utilized their deep understanding of the company's benefits structure and claims history to identify substantial opportunities for cost reduction while ensuring compliance with existing policies.
Our Results
For employers looking to manage healthcare costs effectively, eligibility audits represent a powerful tool that can deliver immediate results without creating additional administrative burden.
Ready to uncover potential savings in your healthcare plan? Contact our Employee Benefits Consultants to learn how our team can help you implement an eligibility audit for your organization.