Errors in Health Benefits Enrollment Data Push Up Health Insurance Costs

Discrepancies in enrollment data between federal agencies' and health insurance carriers' records cause erroneous premium and benefits payments, cause inequities among carriers and employees, and unnecessarily increase health insurance costs for both the government and its employees. Accurate data are needed to determine the coverage provided individual employees, employees' payroll deductions, and the premium payment to carriers, and to insure prompt payment of claims. An audit was conducted that focused on the frequency and effect of discrepancies in enrollment data in two categories: (1) enrollees who were recorded on the records of either federal agencies or carriers but not both; and (2) enrollees who were recorded on the records of both federal agencies and carriers but for whom data differed in those two sets of data.