Spousal health benefits can cost extra with some employers

KHN, whose hospitals include Kettering, Grandview, Southview and Sycamore medical centers and Greene Memorial Hospital, does not charge an employee who enrolls a spouse if that spouse does not work or cannot get health care benefits through his or her employer, Grooms said.

Kettering Health Network has 2,228 health plan members with coverage on a spouse; of those, 794 (36 percent) are paying a spousal surcharge. That works out to more than $825,000 per year.

Some employees removed their spouses from the plan after the new policy took effect, raising KHN’s annual savings to more than $900,000.

Spousal surcharges mean some employees pay more than others for the same benefits. But Grooms said it’s important that employers not be put in a position in which they’re subsidizing employers with less generous health benefits.

“It’s a way to balance the scale,” she said. “I think it’s actually a very equitable way to provide benefits.”

KHN’s competitor, Premier Health Partners, will have spousal surcharges of $55 to $60 per two-week pay period in 2010, Premier spokeswoman Diane Ewing said.

Premier, whose hospitals include Miami Valley and Good Samaritan, and Atrium and Upper Valley medical centers, has 818 employees paying spousal surcharges. It has charged such fees for two years.

The practice isn’t limited to hospitals. Kroger has spousal surcharges for its 58,000 salaried workers and managers, and for some hourly employees working under certain contracts. It charges salaried workers $120 per month.Spousal surcharges have been used locally for about three years, according to McGohan Brabender, a Kettering-based employee benefits broker and consultant. It estimates 1 percent of its 1,500 Dayton-area clients use spousal surcharges.

Premier, KHN and Kroger all have self-funded health plans, but most employers secure health-care benefits through insurance companies regulated by the Ohio Department of Insurance. The department doesn’t have a policy on spousal surcharges and hasn’t decided if they are discriminatory.

“We’re taking a look at the matter,” spokesman Robert Denhard said.

Contact this reporter at (937) 225-7457 or bsutherly@DaytonDailyNews.com.