EMPOWER
Spousal Surcharge Program
Advanced Flex Plan Administration with the Human Touch

Spousal Surcharge Program

A Spousal Surcharge Program (SSP) is a change to the Employer Plan Document that allows the Employer to levy a surcharge to Employees for adding or keeping a Spouse on the employee’s health plan. This can be combined with a Spousal Incentive HRA to further incentivize employees to enroll in their spouses’ plans.

Eligibility

Employers

Any Employer who offers a Group Health Plan can also add a Spousal Surcharge.

Participants

Employees are levied the surcharge (typically a monthly charge) when their spouse is enrolled in the Employer’s Group Health Plan and they do not provide proof for one of the allowed exceptions.

Allowed Exceptions

Employers must waive the surcharge if the employee can provide proof of one of the following exceptions:

  • The employee’s spouse is not presently employed and does not have access to medical coverage through his or her current or
    former employer.
  • The employee’s spouse is self‐employed without access to other medical coverage.
  • The employee’s spouse is covered by Medicare Part A or CHAMPVA insurance and enrolled in an Employer’s medical plan.
  • The employee’s spouse is employed, but the spouse’s employer does not offer medical coverage, or the spouse is not eligible for his or her GHP (Note: Marketplace, Medicare, Medicaid, and Tricare are not considered other employer group health benefits).

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EMPOWER’s Benefits Solutions Guide takes the guesswork out of benefits by providing a comprehensive synopsis of each plan type, as well as comparisons and sample scenarios.

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Click the above link if you are an Employer or Consultant.