Spousal Surcharge

Important: Does not apply to Teamsters Members

Spousal Insurance Surcharge

Spousal Insurance Surcharge programs have gained popularity in recent years as a method to ensure that when spouses of employees have access to their employer’s group insurance, they are encouraged to use their own employer’s health plan.  

Beginning January 2014, employees must pay an additional cost to cover a spouse who has the option to elect health care coverage through their employer. The additional cost, or surcharge, to the University employee will be $100 per month. If the above situation applies to you, you will want to consider how the additional cost may impact your coverage choice.   

During Benefits Open Enrollment in November, you will verify the above criteria through the Employee Self-Service Information System (ESSIC).

To help you determine if the surcharge applies to your situation, please consider the following scenarios:

YES Surcharge:

  • If your spouse is working at an employer who offers group health insurance, but has declined that coverage and wants to remain on the University health plan.
  • If your spouse is eligible and/or enrolled in Medicare, but is still actively working at their own employer, who offers group health insurance.
  • If your spouse is offered coverage for any time period throughout the year with their employer, and you choose to continue their coverage under the Penn State health plan.

NO Surcharge:

  • If you and your spouse are BOTH employed at Penn State and are both covered on the University health plan under either you or your spouse coverage.
  • If your spouse is eligible and/or enrolled in Medicare, but is currently covered on your active employee University health plan.
  • If your spouse is a retiree from another employer, but is not actively working.
  • If your spouse is self-employed, regardless of whether or not they offer insurance to their employees.
  • If your spouse is a part-time employee and has NO access to health coverage.
  • If your spouse has insurance available through their own employer, but the employer makes NO contribution toward the cost of the insurance.
  • If your spouse is a graduate student at Penn State; even though they are offered insurance, they are considered a student, not an employee of Penn State.

Frequently Asked Questions

Will new hires be required to attest to the surcharge?

Yes, they will be asked to make the appropriate selection in ESSIC based on their spouse insurance coverage at the time of hire.

Does the insurance surcharge apply to Penn State’s Dental and Vision plans?

NO, the surcharge applies only to the MEDICAL plan. If your spouse enrolls in their employer’s health plan to avoid the surcharge, they are able to continue coverage or enroll in the Penn State Dental and/or Vision plan.

If my spouse is currently covered on their employer’s health plan, and they lose that coverage, am I able to add them to my Penn State plan?

Yes. Your spouse's loss of coverage would be considered a qualifying event, which means they could be enrolled in the Penn State plan immediately and you would not be required to pay the surcharge. Written documentation from your spouse's employer regarding their loss of coverage would be required, along with a Request for Change in Benefits form, to be submitted to the Employee Benefits office.

If my spouse enrolls in their own employer’s medical plan, can they stay on my Penn State medical plan and use it as secondary coverage?

Yes, they can remain on your Penn State medical plan, but you will be assessed the surcharge.

Are children impacted by the spousal insurance surcharge?

NO, you may cover eligible dependent children on the health plan of your choice, the Penn State plan or your spouse's plan.

My spouse has insurance available through his/her own employer, but the employer makes NO contribution toward the cost of the insurance.  Does the surcharge apply in this case?

NO, the surcharge would NOT apply in this case.

If my spouse becomes deceased or I get divorced during the calendar year 2015, and I am paying the surcharge, will the surcharge be discontinued during the year under either of these circumstances?

Yes, you should notify the Employee Benefits division immediately with your change in status, and we will adjust the surcharge accordingly.