Well Carol, Cheers To Saving $2,400!
SOURCE: City of Tulsa
Non-sworn employees who are enrolled in the City of Tulsa Benefit Plans will incur an annual spouse surcharge of $2,400 ($92.31 per pay period) if their spouse has access to healthcare benefits through their employer but chooses to enroll through the City of Tulsa plan.
What is a spouse premium surcharge?
The spouse premium surcharge is a monthly charge in addition to your regular medical coverage contribution/premium for a spouse who is working and who is eligible for medical coverage through their employer and is covered on the City of Tulsa medical plan.
Why am I being charged the spousal surcharge on my benefits?
During enrollment, employees who enroll a spouse on their medical benefits are required to indicate whether their spouse has access to other health care coverage through their employer. If this question was left unanswered, the spousal surcharge is automatically applied by default.
How much will it cost?
The spouse premium surcharge will be $92.31 per pay period
Is the surcharge deducted before or after income taxes?
The surcharge is a “pre-tax” deduction like your medical premiums.
Why is the City of Tulsa have a spouse surcharge?
The spouse surcharge encourages those participants eligible for other group insurance to take advantage of that coverage. It allows the City of Tulsa to keep our medical plans more affordable. A spousal surcharge is a method adopted by many large employers.
Who pays the spouse surcharge?
It applies to all active employees whose spouse is a dependent on a City of Tulsa medical plan unless one of the following conditions applies:
- Your spouse is not employed and does not have access to other medical coverage.
- Your spouse is self-employed without access to other medical coverage.
- Your spouse is employed, but his or her employer does not offer medical coverage or is not eligible for medical coverage by his or her employer.
(Note: The Marketplace, Medicare, Medicaid, and Tricare are not considered other employer group health plans.)
How will the City of Tulsa know if my spouse has other medical coverage available?
During open enrollment the employee will attest to spouse having access to other coverage or not having access to other coverage. If your spouse has access to medical coverage through their employer, they are subject to a spouse surcharge if you enroll them for City of Tulsa medical coverage. If your spouse does not work, works part time with no access to medical benefits, is not eligible for coverage, has lost coverage as an active employee but has been offered COBRA or is covered by Medicare, the surcharge does not apply.
Note: The company reserves the right to verify if your spouse is provided coverage elsewhere. This information must be consistent with the information you report. Misrepresenting whether your spouse has access to medical coverage may result in disciplinary action up to and including termination.
What if I submit documentation later in the plan year that my spouse did not have access to medical coverage through his/her employer?
The spouse surcharge will be removed as soon as administratively possible upon receiving the supporting documentation. We will not retroactively reimburse for amounts already paid.
Does the spouse surcharge apply to the dental or vision plans?
No, it only applies to the City of Tulsa non-sworn medical plans.
Does the City of Tulsa have the right under data privacy to ask if the spouse is eligible for insurance coverage from another company?
Yes, an employer has a right to inquire about a spouse’s other insurance coverage. Data privacy involves health information specific to an individual’s medical condition or treatment.
If my spouse was offered medical coverage through his/her employer, but the open enrollment window is different from the City of Tulsa, and he/she opted out at the time of open enrollment or the initial offer and isn’t offered coverage access until the next annual enrollment, does the spouse premium surcharge apply?
Yes, the spouse surcharge applies if an individual is offered healthcare coverage at any capacity and opts out of that coverage for the City of Tulsa medical benefits plan.
(The spouse should check with their employer regarding whether their employer will allow him/her to enroll in their health coverage within 31 days of the spouse surcharge change.)
If a spouse is newly employed during the plan year and becomes eligible for benefits elsewhere, would the spouse surcharge be applied at that time?
Yes, if your spouse becomes eligible for a medical plan at their employer, and you choose to keep your spouse covered under the City of Tulsa medical plan, you will need to update your spouse information online at https://compass.empyreanbenefits.com/COT to add the surcharge.