Working Spouse Surcharge
In an effort to keep costs as low as possible for all of our employees and for the State of Georgia’s taxpayers, beginning in 2020 there will be a new surcharge of $100 per month applied to employees who choose to cover their spouses in the USG healthcare plan if the employee’s spouse works for an employer other than the USG and receives an offer of coverage from that employer.
During Open Enrollment, employees enrolled in a USG Healthcare plan and elect to enroll a spouse must complete the working spouse surcharge certification through OneUSG Connect - Benefits.
Working Spouse Surcharge will apply if:
- Your spouse works for any employer other than the USG, has an offer of coverage from that employer, and that employer makes a contribution towards the cost of the coverage. Non-USG employers include private sector organizations as well as other government agencies (i.e. State of Georgia, Department of Education, etc.).
Working Spouse Surcharge will not apply if:
- Your spouse works for USG.
- Your spouse is covered under COBRA.
- Your spouse is eligible and/or enrolled in Medicare or Tricare and does not receive an offer of subsidized coverage through another employer
- Your spouse is self-employed, regardless of whether your spouse offers insurance to his or her employees.
- Your spouse is a part-time employee and has NO access to health coverage.
- Your spouse has insurance available through his or her own employer, but the employer makes NO contribution toward the cost of the insurance.
- Your spouse is not employed.
If you do not complete the working spouse certification during Open Enrollment and out have a spouse enrolled in the healthcare plan, your status will default to the $100 surcharge. No refunds will be given.
Example: If you and your spouse are enrolled in a USG Healthcare plan and do not take action or certify that your spouse is offered coverage from their employer but wish to remain on the USG Healthcare plan Payroll deduction for BlueChoice HMO: $222.98 Working Spouse Surcharge: $100.00 Monthly Pre Tax Total: $322.98
Working Spousal Surcharge — Frequently Asked Questions
Why is the USG adding a working spouse surcharge this year?
- Across the country, healthcare costs are rising, and Georgia tracks closely with national healthcare trends. Overall, USG’s costs are increasing at a higher rate than in the past. In addition, spouses on average cost $100 per month more than employees. USG is adding the surcharge to spouses that have an option of subsidized coverage in their employer’s plan.
Who makes recommendations to make changes to the plan?
- This recommendation was made by the Total Rewards Steering Committee. This committee includes faculty and staff with healthcare or finance backgrounds.
- The committee reviews the data from our plans, as well as benchmarking data, and makes recommendations on the changes to the system office for each plan year.
- These recommendations are presented to the Board of Regents for approval each year.
How long has this surcharge been considered as an option?
- The working spouse surcharge has been considered by this committee for the past several years as a strategy to keep costs lower in our plan for employees or spouses that don’t have any other coverage options. The committee considers many plan changes each year and benchmark our benefits programs to other employer plans and institutions of high education plans. Many other employers have a working spouse surcharge including public and private institutions of higher education.
How did you decide on $100 for a spouse?
- Currently, spouses covered in our plan, on average, cost $100 more than employees per month. Also, when comparing our plan to other employer plans, this amount is similar to the amount charged by other employers.
Shouldn’t the working spouse surcharge amount be based on an employee’s salary?
- Basing premiums or surcharges on an employee’s salary does not take into consideration total household income and could lead to inconsistencies in application of the costs to employees.
Who does the working spouse surcharge apply to?
- The working spouse surcharge applies ONLY to a spouse who is working and has an offer of subsidized health insurance offered by his or her employer. Subsidized coverage means the employer contributes towards the cost of the coverage.
Is a working spouse surcharge common practice today?
- A working spouse surcharge is commonplace among private sector employers. One survey showed approximately 38% of respondents apply a working spouse surcharge if the spouse has access to coverage through another employer. It is utilized in other universities nationwide—see USC and Penn State, for example. It’s important to note the following:
- This only affects working spouses who have the option of purchasing coverage through their employer.
- Based on benchmarking and survey data, USG’s plan actuary estimated that this change may affect approximately 25 percent (or 4,800) of covered spouses (meaning they are employed and would have coverage offered through their employers).
Is this surcharge going to continue next year or is this possibly a one-time trial?
- We will continue to assess the strategies and policies every year to evaluate their results in coordination with rising healthcare costs.
What about my children?
- Costs for dependent children are substantially lower than for employees and spouses.
- One change we did make as part of the working spouse surcharge is changing the “Employee + Child” coverage tier to “Employee + Child(ren).” Currently, employees who coverage two or more children must enroll in the “Family” coverage tier which may encourage employees to continue to cover their spouse under the plan.
- In 2020, an employee covering two or more children without a spouse can enroll in the “Employee + Child or Children” tier and pay less than they would today in the “Family” tier.
Are copays and deductibles going up as well?
- We are making co-pay changes to the USG healthcare plans in 2020. In the Comprehensive Care plan, we are increasing the specialist visit co-pay by $5, from $30 to $35, and increasing emergency room visit co-pay by $100 from $150 to $250. The Kaiser HMO plan will have a specialist visit co-pay increase of $10, moving from $25 to $35.
- There are no changes to the deductibles in 2020.
Is proof required? Will certification be dependent on the honor system?
- Proof of your spouse’s employment status will not be required. Employees will be required to certify that they are making a true statement. Penalties may apply for answering falsely when certifying.
What if my spouse is disabled? Do they still need to certify?
- If you cover your spouse under the USG Healthcare plan, you will be required to complete the working spouse surcharge certification. If your spouse is disabled and not working, the working spouse surcharge would not apply.
When will the change occur? Will it be confirmed before Open Enrollment closes or after?
- The surcharge becomes effective January 1, 2020. You must complete the working spouse surcharge certification when you enroll in your 2020 benefits coverage during Open Enrollment through the oneusgconnect.usg.edu. The 2020 Open Enrollment period is October 28 through November 8, 2019. Once you complete the certification through the enrollment process, you will receive a confirmation that you completed the surcharge certification.
If my spouse has Medicare will they be subject to the surcharge?
- If your spouse has Medicare and is working and receives an offer of coverage from that employer, you would be subject to the surcharge if you cover the spouse under the USG plan. If the spouse has Medicare and does not receive an offer of coverage from another employer plan, the surcharge would not apply.
What about Pre-65 retirees with spouses?
- The working spouse surcharge does not apply to retirees.
What if an adult child is covered under our plan and is offered coverage through their employer?
- The working spouse surcharge does not apply to dependent children regardless of their age.
What happens if my spouse’s coverage ends mid-year and they should no longer be subject to the surcharge?
- To change your working spouse surcharge status mid – year, call the OneUSG Connect call center at 1-844-5-USGBEN (1-844-587-4236)
How can I prove that my spouse is working and not offered coverage?
- The working spouse certification is done through the OneUSG Connect – Benefits website at oneusgconnect.usg.edu or by calling the OneUSG Connect call center at 1-844-5-USGBEN (1-844-587-4236). Documentation is not required.
Will I default into the new tier for child(ren) if I do not cover a spouse?
- Yes. If you cover yourself plus two or more children on the family coverage tier for healthcare, if you do not make an election during Open Enrollment, your coverage will default to the new employee + child(ren) tier.
Is COBRA considered an offer of coverage? Will there be a surcharge for spouses if I go on COBRA?
- COBRA is not considered an offer of coverage from an employer. The surcharge will not apply for spouses who are enrolled through COBRA.
Will the surcharge apply if my spouse is working but coverage is offered in a different state?
- Yes, the surcharge will apply if the coverage is offered in a different state.
What if my spouse is self-employed and has access to individual coverage through the exchange or directly with a carrier, would the surcharge apply to him or her?
- If the spouse is self-employed and obtains individual coverage, the surcharge would not apply.