Limiting coverage on working spouses

[Guest usseryl]

Our plan includes a significant number of working spouses who waive coverage available through their employer so they become primary under our plan. The reason is simple--our plan is extremely rich with many first dollar benefits and the required employee contribution is VERY low. We would like to "steer" more spouses toward electing coverage under their employer so we could become secondary. Does anyone have any suggestions?

[jeanine]

Amend your plan language so that working spouses are required to be covered first under their own employer sponsored health plan. We have seen this happen quite often the past year. (we're a TPA). We refer to this as a "mandatory working spouse" provision. Of course, this will add a little bit of work for you since you'll have to send coordination of benefit inquiries, etc. but you'll save more in the long run. We haven't seen any real backlash from this change.

[PhilB]

Impose an additional "Working Spouse" premium for employees who are married to a spouse that works and is eligible for coverage under their own employer. The additional premium is contingent upon the availability of coverage under the spouses employer, not whether they actually elect the other coverage. If they are eligible and have the other coverage available, then your employee is subject to the additional premium. Otherwise, require proof from the other employer that the spouse is not eligible for the coverage. This is what we do at my company.