Listen to get a better understanding of spousal surcharges and waivers, learn the pros and cons of each, and get Deanna’s expert advice on how to manage these processes.

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Meet Our Guest

understanding spousal surchargesDeanna J. Sizemore
Director of Compliance, Bim Group

Deanna has been in the employee benefits industry for 20+ years, serving both at a carrier and consultant level. She is a graduate of Reinhardt University in Waleska, Georgia, and is pursuing a Master’s in Law through Regent University.

As a licensed Life and Health Consultant, Deanna’s primary focus is on employee benefits auditing and compliance. She has extensive experience in all areas of health and welfare benefit compliance, including ERISA, 5500 preparation, COBRA, FMLA, HIPAA, and ACA. She is a Certified Patient Protection and Affordable Care Act Professional by the National Association of Health Underwriters and currently serves as President for the Central Kentucky Association of Health Underwriter’s board.

You can connect with Deanna on LinkedIn.

Episode Highlights

Understanding Spousal Surcharges and Waivers

  • Trends in recent years
  • What is the difference between a spousal surcharge and a spousal wavier?
    • Surcharge – spouses pay a fee to be added to a plan through their spouse’s employer
    • Waiver – spouses cannot enroll in the employer’s plan unless they do not have access to benefits elsewhere
  • How does the employer manage spousal enrollment and verify?
    • Affidavits and eligibility verification audits

Pros and Cons

  • Pros:
    • The employer saves on healthcare costs
    • Spouses have an opportunity to enroll in the Marketplace
    • A spousal waiver, where spouses can get coverage elsewhere, is a way to save on healthcare costs without the negative company perception
  • Cons:
    • Potential negative impact on employee morale and company perception
    • Could complicate the administration of a family’s medical needs
    • Spousal waivers can increase benefits administration workload

Links and Resources Mentioned

 

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