So my wife recently started working and their insurance package isn't great. She has been on my employee + spouse plan at my employer which has a great insurance package. Last year my employer added a "Domestic Partner Surcharge" in which IF my spouse has access to her own employer medical insurance I would have to pay an additional $150/month as a surcharge to have her on my insurance plan. I read a few articles about how this has become much more common over the last few years but I have a different question.

What happens if I leave everything as is and don't alert my employer that my wife got a job that offers medical insurance? I assume they do random audits in which there is an infinitely small chance that happens to me but would this be a possible issue if there is a large claim?

4 ...

Report Post

Posted by PurpleCrewe

Member since Mar 2015

74 posts

Posted on 5/21/20 at 10:42 am to LSUDbrous90

quote:
What happens if I leave everything as is and don't alert my employer that my wife got a job that offers medical insurance?

If your company doesn’t know your wife had a job change then all stays status quo without you paying the $150 sucharge. Chances are at open enrollment the company will make you check off a box or acknowledge in someway your spouse doesn’t have access to other group health insurance.

As far as large claims there will be no disruption in your wife’s coverage. I’m assuming you work for a large employer and they probably received data that dependents were a heavy percentage of claims. The surcharge is just their way of incentivizing spouse’s away from their plan in hopes so lower claims. All that to say it the company mandating the surcharge not the insurance company so it shouldn’t effect her coverage.

1 ...

Report Post

Posted by LSUFanHouston

NOLA

Member since Jul 2009

37081 posts

Posted on 5/21/20 at 11:10 am to LSUDbrous90

I am sure there is some fine print somewhere in the forms you sign that if any covered person has a "life status change" that negatively impacts their eligibility at the current offered price, that you are required to notify them.

Like the other poster said, this charge is a charge from your employer, not a charge from your insurer. So, your wife's coverage should be fine.

However, your company may not be a fan of you failing to disclose information to them. I guess they could take action including nothing to charging you retroactive for the additional premium, to terminating you for cause.

0 ...

Report Post

Posted by LSUDbrous90

Lafayette

Member since Dec 2011

1450 posts

Posted on 5/21/20 at 11:28 am to PurpleCrewe

I haven't seen anything asking about wife's employment or anything. I am not even sure if/when she eligible for insurance through her employee anyway. Also, thank you for the clarification that it is an employer thing and not an insurer/coverage issue. It is all pretty confusing so I think I am just going to choose to hold off for now as I do not think it is an issue. Thanks for the feedback.

0 ...

Report Post

Posted by tigercross

Member since Feb 2008

4918 posts

Posted on 5/21/20 at 5:44 pm to LSUDbrous90

I'd just pay the $1800/yr for peace of mind. If they did find out, they could term you on the spot.

0 ...

Report Post

Posted by yellowfin

Coastal Bar

Member since May 2006

97632 posts

Posted on 5/22/20 at 6:10 am to LSUDbrous90

quote:

What happens if I leave everything as is and don't alert my employer that my wife got a job that offers medical insurance? I assume they do random audits in which there is an infinitely small chance that happens to me but would this be a possible issue if there is a large claim?

If spouse is employed we require a letter from employer stating they are not offered insurance. If spouse is unemployed we require a letter signed by both stating they are unemployed.

Require a new one annually

This post was edited on 5/22/20 at 6:11 am

Page 1