Dependent Eligibility Audit

[Zorro1k]

When a plan does a dependent eligibility audit and does not receive supporting documentation it requests for participants it now assumes may not be covered, what are the rules for removing a covered person or their beneficiary? What documentation can a plan request?

[jsb]

The plan should operate consistently with its own plan documents. It may require proof of dependent status, if it chooses. Should also require dependent's SSN as it must be reported to the IRS next year. If the plan requests documentation, and the employee doesn't provide the proof, the dependent isn't eligible and should be removed from the plan, or not added as a new enrollment. An employee knowingly adding, trying to add, or retaining an ineligible dependent would be committing fraud against the employer, a terminal offense at most employers.

[Chaz]

If this is other than a hypothetical question, you should consult with counsel. There are a lot a fact-specific issues involved that don't lend themselves to a generalized answer. As jsb mentions, though, the place to start is to review the plan document and SPD as well as any open enrollment information that the employer distributes and collects from employees.