KNOWLEDGE CHECK

Health & welfare plans
Internal controls/service organizations

Health & welfare plans
Internal controls/service organizations

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* The auditor should obtain an understanding of the internal controls in place at the plan sponsor and the service providers. All of the following are examples of internal controls related to claims paid in a health and welfare plan, except:

Periodic reconciliation of contributions received from the plan sponsor to the amounts received in the plan.

Periodic vendor history claim reports are reconciled to reimbursements paid to the third party service provider.

Periodic targeted claims audits are performed to determine proper adjudication of individual claims.

Review third party service provider reports for stop loss reporting.

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