Spousal surcharge

Considerations
When considering whether to enroll your spouse, consider your employee discount, which applies to your while family. Click here for a list of the insurance plans accepted by RHS facilities and providers.

What is the spousal surcharge?
The spousal surcharge is an additional premium that will apply when your spouse works full-time and has access to group health coverage from his or her employer but elects to decline that coverage, using Riverside Health System's health plan for primary coverage instead. The 2014 spousal surcharge will increase to $200 per month or approximately $92.31 per pay period.

If my spouse chooses Riverside Health System's health insurance because her company doesn't offer insurance, or my spouse is self-employed, would the surcharge apply?
No.

What if my spouse quits or loses his job but has access to COBRA. Does COBRA constitute employer-sponsored coverage?
No. The spousal surcharge applies to those who are employed full-time and have access to employer-sponsored health care. COBRA coverage would not qualify as employer-sponsored health care. Medicare would not qualify as employer-sponsored health care, either.

My spouse is unemployed. Do I have to pay the surcharge?
No.

My spouse is retired and has coverage based on his retirement. Do I have to pay the surcharge?
No. That is why the spousal surcharge is often called the working spousal surcharge.

If my spouse does not have a job during Riverside's annual enrollment but starts working after I have elected to cover her under Riverside, do I have to pay the surcharge?
Yes, you will need to notify Total Rewards (Benefits Services) of this change. Please note that if your spouse becomes employed after the plan year begins, this is a qualifying event that will allow you to make new elections under Riverside's health plan. For example, you could choose to terminate your spouse's coverage under Riverside's plan and he/she could become covered under his/her employer's plan.

My spouse works full- time and wants to elect Riverside's benefits as primary coverage, even though his employer also offers health care coverage. Do I have to pay the surcharge to use Riverside as his primary benefits provider?
Yes, you will have to pay a surcharge for benefits under the Riverside health care benefit plans.

If my spouse is covered by Medicare, a Medicare individual policy, or Medicaid, will the surcharge apply?
No.

If both me and my spouse work at Riverside Health System, will the surcharge apply?
No.

What happens if my spouse picks-up coverage at his/her employer and sends in notification of their other coverage at a later time?
Upon receipt of a letter from the other employer showing the effective date of the group health insurance coverage, the spousal surcharge will be discontinued the first of the month following the receipt of the documentation. The documentation must be submitted within 30 days of the effective date of other coverage. No refund of health insurance premiums at the higher rate will be made.

Is the spousal surcharge deducted before or after income tax?
The spousal surcharge will be included with the health care premium, so it is deducted before income taxes.

 


 

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