Diplomatic Relations: Reconsidering Spousal Coverage

The Affordable Care Act (ACA) doesn't require spousal coverage — only coverage for dependent children. For this reason, as employers continue to grapple with high plan costs, many are reconsidering whether and how to offer health care insurance to their employees' spouses.

The dollar savings are there for the taking. But many employees would likely frown on seeing spousal coverage suddenly become expensive or vanish entirely. So this isn't only a financial issue; it's also a diplomatic one calling for careful forethought.

Surcharges and carve-outs

Essentially, there are two established ways of saving money on spousal coverage: 1) rationalizing the expense through a cost-sharing surcharge, or 2) eliminating coverage altogether through a "spousal carve-out" policy.