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In the small group health insurance industry there has been a huge increase in carriers auditing their clients. The audit consists of the carrier requiring the client to provide up today wage n tax information. The carrier is looking to see if the group is still compliant form a participation standpoint.
In the past very few customers would receive an audit. In 2011 there has been a much higher increase from national carries like Anthem and UnitedHealthcare calling for audits on renewing groups. I think the high increase of audits might have something to do with the Medical Loss Ratio in the new health care law. It is my belief that high claims groups might be targeted for these audits. My view on this is pure speculation but I am seeing a trend.
In the past we would only see an audit if there was a large decrease in participation in the plan.
If you are the owner or a controller of a small group health plan be very aware of the audit. If your group is not meeting participation it might be time to address that issue before you are forced to.
