Healthcare Benefits Audit Checklist Form
Use this form to review healthcare benefits administration, confirm coverage and enrollment checks, and record audit findings. This form is for operational auditing only and does not collect sensitive health information.
Audit Identification
Audit Date
*
-
Month
-
Day
Year
Date
Auditor Name
*
Department or Business Unit
*
Plan Year or Review Period
*
Coverage and Enrollment Review
Employee eligibility verified
Yes
No
N/A
Enrollment records current
Yes
No
N/A
Coverage effective dates reviewed
Yes
No
N/A
Dependent coverage records checked
Yes
No
N/A
Terminations or changes reflected accurately
Yes
No
N/A
Notes on discrepancies found
Communication and Documentation Review
Benefits summary reviewed
*
Yes
No
Partial
Not applicable
Open enrollment communications reviewed
*
Yes
No
Partial
Not applicable
Plan documentation available
*
Yes
No
Partial
Not applicable
Employee notification records reviewed
*
Yes
No
Partial
Not applicable
Missing documents or communication gaps
Submit
Should be Empty: