Client Overview
A leading pediatric health system in Texas, and one of the largest in the United States, provides care to more than 250,000 patients annually across 40+ locations. With more than 1,300 medical and dental staff, 1,000 physicians and 7,000 support staff, the organization is recognized as a top workplace and committed to making children’s lives better.
The Challenge
As a nonprofit, the health system faced rising healthcare costs associated with its self-funded plans. Without a formal process in place to verify each dependent’s eligibility, there was potential for unnecessary expense. A working spouse provision had also been introduced, but with no mechanism to confirm whether spouses had access to other coverage, compliance relied entirely on the honor system. Maintaining trust with employees while managing the plan responsibly was essential.
Our Approach
Lumelight experts partnered with the organization to deliver a comprehensive dependent eligibility verification program that included validation of working spouse coverage. Through co-branded communications, a secure online portal and access to a US-based support team, employees were guided through each step of the process with ease and clarity.
The Results
The initiative delivered meaningful value in the first year. Lumelight experts helped the health system confirm that covered dependents and spouses met the requirements of the plan, resulting in significant projected cost savings and improved enforcement of the working spouse provision. The process also delivered a high level of employee engagement without straining HR teams or disrupting the employee experience.
