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Doubling Up: Some Details on Spousal Coverage

Insurance Forums Staff

Parsing out the details of employee benefits can be challenging when it comes to spousal coverage.  One producer asked the forum community whether it is legally compliant for an employer to exclude spousal coverage, if the spouse is offered coverage from another employer.

Producers weighed in that in general, the employer can deny spousal coverage in the case that the spouse already receives coverage from his or her own employer.  However, they noted that it is better to have more details, and find out whether these cases are addressed in the paperwork, whether there is paperwork or IRS forms to file.

In general, it is important to highlight eligibility in enrollment materials and employee guidebooks.  There should also be workflows in pace for dealing with eligibility, in the case where you need to verify that the spouse has coverage, and whether there is an appeal process from the employee.

Weigh in on the ins and outs of spousal coverage right here.



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