Charging a higher medical premium?

The Prez of our company is adamant about implementing this program with the 2006 insurance renewal: Charging a higher medical insurance premium to an employee who's spouse has medical coverage available through their own employer, but they prefer to be covered under our policy. Do other companies do this, and what kind of administrative difficulties, if any, have you experienced? Our insurance broker has indicated that (in his opinion) it would be a lot of work for little gain, and would be negatively received by the employees. Yet our Prez is quite adamant about saving money in this way. Our company is doing very well financially. To implement this program would actually mean some ee's would still have to pay a family premium if they have 2 or more children on the plan, and their spouse would also have to pay premiums for their own coverage, thus costing them more money. Apparently ee's would have to sign an affidavit stating their spouse DOES NOT HAVE other coverage available to them. I see this as being administratively burdensome, a defeat to employee morale, and potentially lead to terminations if the ee lies re: the availability of coverage to the spouse. Can you share success or horror stories, or your company's experiences? We are a manufacturing company of over 500 ee's.

Comments

  • 12 Comments sorted by Votes Date Added
  • Your prez is a visionary! But his/her Modest Proposal doesn't go far enough -- you should have your entire compensation system based on need. You should charge extra if the EMPLOYEE is covered on his spouse's health insurance. Same with kids. As for life insurance, cancel their coverage if they buy another policy on their own.

    In fact, ees with working spouses should be paid less than other employees, based on your boss' logic. :~~ And don't forget to factor in their kids' summer jobs!

    I hope your prez announces this new policy in a company meeting. Please videotape it and send me a copy. x}>

    James Sokolowski
    HRhero.com
  • I don't know how much different this is than those employers who PAY their employees to get off their insurance and onto their spouse's plan. Most people don't seem to have a problem with that scenario. (Except me)

    I don't know anyone who's doing this, but, in general, I've always thought that each employer ought to 'carry their own load', in other words, provide insurance at least on their own employees. That said, with today's cost and coverage differences, it would be tough to force an employee's spouse onto their own plan which is substantially lower in benefits and higher in cost than keeping them on our plan, but, of course, if our employee was already paying for family coverage, it would be secondary to the spouse's plan and the benefits levels would be equivalent. Tough choice.

    Go for it, and tell the rest of us how it works out. :)
  • We're contemplating this for next year as well. Our funding is getting cut 5% now & we're facing another 20% reduction if the state budget passes this year. As a non-profit, 25% is a chunk of change so we're looking at everything. Charging extra may cause some employees to drop the spouse coverage thus saving us premium dollars. Also, we have an aging workforce and getting the spouse off will help our experience rating so hopefully we won't face a huge premium increase next time around. Good Luck!
  • I don't think so. We offer medical coverage to our employees as a benefit and to stay competitive. To charge an employee extra because their spouse has coverage AVAILABLE to them is absurd.

    A better way would be to offer an incentive (read $$) to opt out of his plan and into their spouses plan. This is then the employee's choice. Works for us.
  • See Don D's post in "Forced Health Benefits" written by PattyO. May help a little :)
  • [font size="1" color="#FF0000"]LAST EDITED ON 04-20-05 AT 12:10PM (CST)[/font][br][br]Yes, please do. We are an Eight Billion annual dollar company and this is one of the hallmarks of our insurance policy. Benefits are offered to stay competitive, as Ritaanz said; however, benefits are not social packages and are not gifts to families and are not there to help the employer go broke or force the employer to raise employee premiums, which is exactly what happens when the features of the group plan are open on an unrestricted basis. Each employee has to fill out a form at annual open enrollment time in November and the spouse has to fill out a portion as well. Employees whose spouses have available coverage but opt to clog up our policy with those spouses and their medical issues, are charged a much higher premium.

    By the way, we're the same corporation that makes it's employees submit proof of dependents relationship before we will add those dependents. Our corporate experts say this has saved us over a million and a half dollars since it was installed two years ago.

    Visionary indeed. These are just two reasons why our group policies are so competitive and premiums are excalating at a much slower pace than most and part of the reason we continue to be an $8B corporation.

    On the other hand, employees and spouses who went online and participated in a personal health evaluation program got monthly discounts of up to $30. The exercise was confidential and took about 13 minutes and many decided it was a waste of time. We push that just like we do our EAP.
  • Don, very interesting. How much do your employees, with dependents, pay for their medical coverage? Those with available coverage elsewhere, how much higher?

    Proof of relationship .... I'm assuming a birth certificate for a child. What do you do if the last name is different? How far do you pursue this? Your input will help me sell this to our VPs.
  • Benefit enrollment form - Dependents information sheet requires name, relationship, proof and date of marriage, birth certificates of dependents or notarized affidavit attesting as to status as stepparent, guardian, custodial parent.

    Spousal Employment Verification Form has multiple questions and required a confirmation signed by a representative of spouse's employer as to ineligibility for other coverage. And states misrepresentation is cause for termination.

    We have four types of plans available with different costs, deductibles, etc.

    EE plus two or more:
    Plan A total cost per month $1085
    Employer pays $932
    Employee pays $122
    Includes discounts for choosing standard prescription option and for participating in the healthy people audio/video computerized program.

    The $122 above, becomes $430 if spouse declines other coverage.


    In my case, ee plus spouse, Plan A:
    Total cost per month $641
    Employer pays $541
    Employee pays $76
    Includes discounts as stated above.

    If my spouse declined the coverage available at her job, my monthly cost would rise from $76 to $377

    So, as you can see, if I had a spouse and 5 kids (or any number) the coverage would cost me $122 per month. I don't find many plans that match or beat that with $150 deductible and $1000 out of pocket.
  • What if the spouse doesn't work?
  • Then we tell the employee he must save enough weekly to pay her medical expenses. x:-)

    No, Section one of the form goes like this:
    Are you opting out of the plan? yes no
    Are you married? yes no
    Is your spouse employed? yes no
    Will your spouse be covered under our medical plan? yes no
    Does your spouse work for us? Yes No

    Section two asks for name, address and telephone number of spouses employer, whether or not spouse is full time. Then gets into the questions about whether coverage is offered and whether spouse is eligible, and if so whether enrolled. Etc.

    If the spouse is either not eligible where employed, or unemployed, spouse is allowed to join our plan just as any other dependent without penalty.


  • No one has asked this question: If your spouse elects coverage from her employer, AND your ee wants to add the spouse to your plan in order to carry supplemental insurance, how would that effect the premium charged to your ee?
  • No penalty. Spouse has secondary coverage with our plan under ee plus 1 or ee plus family, depending on family size.
Sign In or Register to comment.