Why Employers Should Make 2026 the "Year of Dependent Eligibility Verification"
By David Chojnacki, President at Verifi1
NOVEMBER 18, 2025
As the 2025 open enrollment season winds down, many employers assume they can “take a deep breath.” But right after open enrollment is actually the best time to launch a dependent eligibility verification initiative (DEVA). Once the new year begins, life event changes, new hires, terminations, and plan updates start flowing in fast - and that’s exactly when dependent eligibility starts drifting. A "clean file" on January 1 quickly can become a "messy" file by March if no one’s watching.
Compounding the challenge is the reality of rising medical costs. The Business Group on Health projects a nearly 8% average cost trend growth for 2025, Aon forecasts 9.5% in 2026, and the Kaiser Family Foundation reports average family premiums nearing $27,000 a year. In a world where most employers are self-funded, every ineligible dependent isn’t just a clerical issue, it’s a claims liability. If an ineligible dependent racks up $25,000 in claims, you (not your carrier) are footing the bill. Think of it like leaving every light on in the office building 24/7, and then wondering why the electric bill exploded.
The broader environment isn’t helping. The recent government shutdown left ACA subsidy questions unresolved, and many enhanced tax credits lapsed. When individual market premiums go up, pressure shifts back onto employer plans, making fraudulent or opportunistic dependent enrollments more likely. As one benefits manager once told me: “Offer a great health plan and watch how quickly someone's family tree mysteriously expands.”
The solution is straightforward: verify dependents early in 2026, tighten eligibility files, and communicate clearly to employees that this is standard good governance, not a witch hunt. Most employers uncover 5–10% of dependents who are ineligible, costing hundreds of thousands (or more) of dollars annually. And yes, sometimes the audit turns up surprises (Case in point: “We applaud your loyalty to Grandma, but the plan doesn’t include a "family legend" eligibility category!”)
In an environment of rising medical inflation, regulatory uncertainty, and budget pressure, a DEVA initiative isn’t simply a “nice-to-have” option - it’s responsible plan stewardship. And if you’re self-funded, it’s simply good business.
Don’t pay for dependents who aren’t eligible. Don’t guess about who’s covered. And don’t wait for a spike in claims to find out you’ve been paying for people you never should have covered in the first place.