Removing working spouses or adding a spousal surcharge provision provides greater savings than a dependent audit.
While spousal surcharge programs as well as mandated removal programs are great cost containment strategies, actual health plan savings are only as good as the integrity and awareness of the participating employees. Rare is the plan that has optimized its potential. This really shouldn’t be too surprising given the results most dependent eligibility audits generate. After all, it is widely known the majority of dependent eligibility audits remove 5% - 10% of the members. Evasive “spousal surchargers” or “non-removals” share many of the same root cause characteristics as ineligible dependents.
Given the fact that 75% of removed dependents from a dependent audit are children, the real savings come from removing ineligible spouses. And that’s the point of auditing working spouses. Auditing working spouses is 1) Less invasive than a dependent audit and 2) Provides materially greater savings than a dependent audit.
HR Best Practices has developed a proprietary, predictive modeling methodology to help plans remove ineligible working spouses with other coverage.
Regardless of the approach, the financial savings are compelling. Given the average surcharge of $100 per month, employers can’t run the risk of missing out $1,200 annually for each non-participating surcharger, plus given healthcare costs associated with spouses, both insured and self-insured plans can enjoy savings closer to the per capita spouse cost.
Separately, if you’re thinking about implementing a spousal surcharge or a working spouse provision, but aren’t sure what savings the program will generate, our healthcare cost containment team will be happy to perform a data-driven analysis. Call us today at 201.891.8010 to discuss how our proprietary spousal surcharge and working spouse auditing methodology can help your plan generate additional contributions or save more than a dependent eligibility audit.
