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Health Care Cost Sharing: Spousal Coverage Options


Understand the pros and cons of a spousal surcharge or carve-out and prepare for successful implementation of any changes.

Many employers are facing significant health plan cost increases again this year, even after taking cost-management initiatives into account. Some are changing their approach to spousal coverage in an effort to manage costs. This topic will discuss health plan spousal surcharges and spousal carve-outs and the differences between them. The material will review the pros and cons of each approach, address potential legal issues, and identify the health plan features, cost-sharing structures, and population demographics of plans that realize cost savings with a spousal surcharge or carve-out. Proper implementation of any benefit change is key to its success. This information is critical for employers considering changes to spousal coverage so they can determine whether their organization may benefit from a spousal surcharge or carve out and prepare for successful implementation of any changes.



Kelly Haab-Tallitsch

Kelly Haab-Tallitsch

SmithAmundsen LLC

  • Partner at SmithAmundsen LLC
  • Regularly counsel’s clients on employee benefit compliance, helping employers understand their obligations under the Affordable Care Act, ERISA, and the Internal Revenue Code
  • Advises employers on health and welfare plans, wellness programs, qualified and non-qualified retirement plans, employee stock ownership plans (ESOPs), deferred compensation, equity plans and employee benefit issues arising out of mergers and acquisitions
  • Defends clients against general employment discrimination claims and handles matters such as Department of Labor benefit plan audits and correcting plan errors through the Department of Labor and Internal Revenue Service voluntary correction programs
  • J.D. degree, Northern Illinois University College of Law; M.S. degree in industrial relations, Loyola University Chicago; B.S. degree, University of Illinois at Urbana-Champaign
  • Can be contacted at 630-587-7927 or at [email protected]

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