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Cutting out spouses to save on costs

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Among plan design tweaks becoming more common are surcharges for spouses who are able to obtain coverage from their own employers.

Surcharges and even exclusions are “levers we've seen a lot of employers take a look at,” especially if “there are a lot of spouses on (the employer's) high claimants report,” said Michael Booth, president of Westmont, Illinois-based Axion RMS Ltd.

It's a strategy the United Parcel Service Inc. undertook in 2013, when it quit offering health insurance to spouses who could obtain coverage from their own employers, citing the health care reform law and rising premiums as its motives.

Since then, more employers have followed suit.

Thirty-four percent of employers will add spousal surcharges in 2016, compared with 29% in 2015, according to the National Business Group on Health. Only 4% will exclude spouses from the plan if similar coverage is available to them.

For middle-market and small employers, interest is growing in self-funding their health plans.

Employers want to be self-funded “because of the data that is available to them that enables them to put together ... a strategic action plan for the next five years,” said Luke Barnett, practice leader and employee benefits consultant at Chicago-based firm Connor & Gallagher Insurance Services Inc.

Fully insured employers “get very little data about how your employees are using your plan” and “little info about the efficiency of your premium dollar,” he said.