PPACA Accelerates Employer Trend Toward Penalizing Spouses Who Join Their Health Plan, Study

The Patient Protection and Affordable Care Act (PPACA) does not require an employer to offer spousal healthcare coverage but does mandate employers cover eligible dependent children. Employers generally use two methods to control health care costs by placing restrictions on coverage for an employee’s spouse.

1. Some plans disallow spouses onto the employer's plan entirely. 
2. While others take the more common approach of passing on most, all, or even more than 100% of the cost of that additional spouse to the employee. 

Most of these approaches, however, apply such restrictions only to spouses who have coverage available from another employer and choose not to significantly penalize a nonworking spouse.

While this trend has existed for more than a handful of years, it has accelerated under PPACA as employers become desperate to trim costs however possible.  And since PPACA does not mandate the employer offer coverage to a spouse, by default, this becomes one of the available techniques.  

A new study from the actuarial firm Conrad Siegel Actuaries of 130 companies from a range of industries has illuminated this growing trend.  

• In 2012, 20% of companies either charged spouses for coverage or excluded them. 
• In this year’s survey based on 2014 data that shot up to 47%. Of that 47%, 
• 31% offer no spousal coverage at all (up from 25% in 2013) and the remaining
• 16% penalize with a surcharge. 
• The average surcharge is $1,700 a year or $142 per month.