The company that I work is in their open enrollment for benefits, health, dental, etc. But this year is different because now my company want to tack on a $40.00/ per month surcharge due to the fact that my spouse is eligible to pick up her own health insurance at her own place of employment. My HR person said it's because the company has noticed that the spouses are actually costing more that a child in terms of healthcare cost. (Funny thing is that I work for a a large Nursing / Rehab chain) Is this even legal??? A penalty because my company thinks my wife should be on her own plan? Never mind the fact that the insurance that her company offers is way worse. Is this even legal?? The HR person said that i can check off (and lie) that she is not eligible and not pay the surcharge. Can my company even check this? I also don't feel like being fired for lying.
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Surcharge on Health Insurance
- Thread Starter shawn2102
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cbg
Super Moderator
Yes, it is legal.
Keep in mind that there are only two states where an employer is required to provide health insurance coverage to their employees in the first place, and they are not required to provide it to dependents even when they do. It is both legal, and becoming quite common, for employers to set the eligibility requirements to make it advantageous for dependents who have access to their own coverage, to take it.
Shame on your HR manager. If she worked for me, I'd fire HER.
Keep in mind that there are only two states where an employer is required to provide health insurance coverage to their employees in the first place, and they are not required to provide it to dependents even when they do. It is both legal, and becoming quite common, for employers to set the eligibility requirements to make it advantageous for dependents who have access to their own coverage, to take it.
Shame on your HR manager. If she worked for me, I'd fire HER.
So I understand an employer's rationale on instituting a spousal surcharge.
However what I don't agree with, or understand how it is legal, is for a company to charge a surcharge to employees who have a spouse who is employed and have been offered health care by their employer, while not requiring a surcharge for a spouse who is either unemployed, or who does not have access to insurance through their employer. The surcharge is in addition to the premiums the employee pays for the health care coverage.
An employee who is married whose spouse has not been offered health coverage by thier employer would not be surcharged.
In both situations the coverage is exactly the same, same premiums ,yet one employee is charged $xxxx more (surcharge) by the employer for the same coverage.
This seems discrimatory... charging more to one group of people for the same services, just because their spouses have access to insurance elsewhere.
Is this legal for an employer to charge/surcharge some employees purely because the spouse was offered health care coverage ?
If a company elects to offer health insurance to one's spouse, I feel the premium/surcharge should be the same amount regardless is the spouse has access to health care coverage elsewhere.
However what I don't agree with, or understand how it is legal, is for a company to charge a surcharge to employees who have a spouse who is employed and have been offered health care by their employer, while not requiring a surcharge for a spouse who is either unemployed, or who does not have access to insurance through their employer. The surcharge is in addition to the premiums the employee pays for the health care coverage.
An employee who is married whose spouse has not been offered health coverage by thier employer would not be surcharged.
In both situations the coverage is exactly the same, same premiums ,yet one employee is charged $xxxx more (surcharge) by the employer for the same coverage.
This seems discrimatory... charging more to one group of people for the same services, just because their spouses have access to insurance elsewhere.
Is this legal for an employer to charge/surcharge some employees purely because the spouse was offered health care coverage ?
If a company elects to offer health insurance to one's spouse, I feel the premium/surcharge should be the same amount regardless is the spouse has access to health care coverage elsewhere.
It is not discriminatory because your company does not have to offer any benefits at all, and it is costing your company alot of money to add your wife and cover her so I think the surcharge is fair. Also your wife needs to inquire about an HRA acct. Since she does not take her own companies insurance, they may give her an out of pocket allowance for healthcare costs.
Spousal Surcharge in addition to Family Plan
I understand the above posts concerning the legality and financial incentive for a company to add a spousal surcharge. However, does the same hold true when you consider Family Plans?
Allow me to explain. I am a public school teacher and receive health insurance "free" of charge. I added my wife for the "+1" option and paid roughly $50 a month for the added benefit. Once we had kids, we shifted to the "Family Plan" for $150 a month. This family plan has no limit on the number of dependents covered.
This coming January, our county benefits department will be charging $200 a month for a spousal surcharge. This will be on top of the $150 contribution for the Family Plan. I understand the previous post that said adults are more expensive to cover than children, but doesn't it stand to reason that if you are offering a Family Plan with no limits on number of children, then it should also include the spouse for no additional cost? Is this change in policy by the county defensible? Based on teacher salary in my district, this additional spousal surchage will amount to a 6% decrease in salary.
Second question would be concerning a privacy issue. I know this is a tenuous argument considering I am choosing to enroll my spouse in an optional coverage/benefit that the county does not have to provide. However, are companies/employers allowed to verify the employment status (and access healthcare insurance through the other employer) of an employee's spouse?
Thank you for your thoughts on this matter,
Parker
I understand the above posts concerning the legality and financial incentive for a company to add a spousal surcharge. However, does the same hold true when you consider Family Plans?
Allow me to explain. I am a public school teacher and receive health insurance "free" of charge. I added my wife for the "+1" option and paid roughly $50 a month for the added benefit. Once we had kids, we shifted to the "Family Plan" for $150 a month. This family plan has no limit on the number of dependents covered.
This coming January, our county benefits department will be charging $200 a month for a spousal surcharge. This will be on top of the $150 contribution for the Family Plan. I understand the previous post that said adults are more expensive to cover than children, but doesn't it stand to reason that if you are offering a Family Plan with no limits on number of children, then it should also include the spouse for no additional cost? Is this change in policy by the county defensible? Based on teacher salary in my district, this additional spousal surchage will amount to a 6% decrease in salary.
Second question would be concerning a privacy issue. I know this is a tenuous argument considering I am choosing to enroll my spouse in an optional coverage/benefit that the county does not have to provide. However, are companies/employers allowed to verify the employment status (and access healthcare insurance through the other employer) of an employee's spouse?
Thank you for your thoughts on this matter,
Parker
cbg
Super Moderator
Thressa, please check the dates before you post.
Spouse uses other health plan AND spouse's health plan
My husband's employer writes its own health plan but Wellmark Blue Cross and Blue Shield of Iowa administers it. He is enrolled in the Family plan. My employer provides Wellmark Blue Cross and Blue Shield of Iowa and I am enrolled in the single plan. Other than small premium increases, both of our plans have remained consistent over the past 15 years.
Because my husband's plan has a co-pay for office visits and prescription drugs I have been using his insurance as my primary and my insurance as my secondary. Each of us pay a premium for our plan.
Based on 2011 changes to my husband's plan I would like to know if it is illegal for me to use two separate plans. What is new with the health plan in 2011 is $2,500 deductible for family, out of pocket maximum is $5,000, instead of co-pay there will be 20% coinsurance, and an additional $60 co-pay for Specialist Office Visit plus an annual premium increase of $108.45. The company will also charge a $35/month surcharge to those who choose to cover spouse on the company plan, if the spouse has coverage available through own employer but chooses not to enroll in that coverage. Based on the language in the form that must be completed and returned to his employer no later than December 13, 2010, there is no criteria from which to choose that addresses the spouse opting for double coverage. If we simply ignore the form the surcharge will be deducted [from paycheck on a pre-tax basis] starting January 1, 2011 The form also requests spouse name, spouse employer, and spouse employer phone # as well as spouse signature and date acknowledging disciplinary actions for false statements.
1. Is it illegal to be covered by two health insurance plans?
2. I am not an employee with my husband's company, why am I required to sign any form for his HR department?
3. What is meant by the statement, "If you or your spouse opts out of Company's Health Plan due to the availability of other coverage, you will not be allowed to enroll in Company's Health Plan again unless a HIPAA qualifying event occurs"?
4. Would it be uneithical to speak with my company's corporate attorney about this matter?
My husband's employer writes its own health plan but Wellmark Blue Cross and Blue Shield of Iowa administers it. He is enrolled in the Family plan. My employer provides Wellmark Blue Cross and Blue Shield of Iowa and I am enrolled in the single plan. Other than small premium increases, both of our plans have remained consistent over the past 15 years.
Because my husband's plan has a co-pay for office visits and prescription drugs I have been using his insurance as my primary and my insurance as my secondary. Each of us pay a premium for our plan.
Based on 2011 changes to my husband's plan I would like to know if it is illegal for me to use two separate plans. What is new with the health plan in 2011 is $2,500 deductible for family, out of pocket maximum is $5,000, instead of co-pay there will be 20% coinsurance, and an additional $60 co-pay for Specialist Office Visit plus an annual premium increase of $108.45. The company will also charge a $35/month surcharge to those who choose to cover spouse on the company plan, if the spouse has coverage available through own employer but chooses not to enroll in that coverage. Based on the language in the form that must be completed and returned to his employer no later than December 13, 2010, there is no criteria from which to choose that addresses the spouse opting for double coverage. If we simply ignore the form the surcharge will be deducted [from paycheck on a pre-tax basis] starting January 1, 2011 The form also requests spouse name, spouse employer, and spouse employer phone # as well as spouse signature and date acknowledging disciplinary actions for false statements.
1. Is it illegal to be covered by two health insurance plans?
2. I am not an employee with my husband's company, why am I required to sign any form for his HR department?
3. What is meant by the statement, "If you or your spouse opts out of Company's Health Plan due to the availability of other coverage, you will not be allowed to enroll in Company's Health Plan again unless a HIPAA qualifying event occurs"?
4. Would it be uneithical to speak with my company's corporate attorney about this matter?
Proserpina
Moderator
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