Companies can charge more for spouse coverage, state says

Businesses who purchase private health insurance may not exclude a spouse from a plan if they have other available coverage. But companies can charge employees more for health insurance for their spouse if their spouse can get insurance elsewhere, such as through his or her own employer.

That’s the recently devised policy of the state Department of Insurance, according to the department’s chief policy officer, Doug Anderson. The department regulates only the private insurance market in Ohio, not employers that have self-funded ERISA (Employee Retirement Income Security Act) plans, which are regulated at the federal level.

Anderson said on Tuesday, Jan. 12, that the spousal surcharge practice, which has been used for some time by larger employers that are self-insured, appears to be filtering down to smaller employers who buy health insurance for their employees.

The Dayton Daily News in November reported some local employers charge workers more if they include on their health plan spouses who can get benefits elsewhere, including Kettering Health Network, Premier Health Partners and Kroger. (All three have self-funded health plans.) At that time, the Department of Insurance did not have a policy on spousal surchages and said it hadn’t decided if they were discriminatory.

Contact this reporter at (937) 225-7457 or bsutherly@DaytonDailyNews.com.

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About the Author

Ben Sutherly