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Subject: Medical Plan Spousal Surcharge effective January 1, 2023In our commitment to encourage health and wellness within our employee population, we also want to make sure medical coverage is available
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How to fill out spousal surcharge - human
How to fill out spousal surcharge - human
01
Obtain the spousal surcharge form from your employer or healthcare provider.
02
Fill out your personal information including your name, address, and employer information.
03
Provide your spouse's information including their name, date of birth, and employment status.
04
Indicate any other insurance coverage your spouse may have.
05
Sign and date the form before submitting it to the designated department.
Who needs spousal surcharge - human?
01
Anyone who is eligible for health insurance coverage through their employer and has a spouse who also needs coverage may need to fill out a spousal surcharge form.
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What is spousal surcharge - human?
Spousal surcharge is an additional fee imposed on an employee's health insurance premium when their spouse has access to health insurance coverage through their own employer.
Who is required to file spousal surcharge - human?
Employees who have a spouse with access to health insurance coverage through their own employer are required to file spousal surcharge.
How to fill out spousal surcharge - human?
To fill out spousal surcharge, employees need to indicate whether their spouse has access to health insurance coverage through their own employer.
What is the purpose of spousal surcharge - human?
The purpose of spousal surcharge is to discourage employees from enrolling their spouse in their employer-sponsored health insurance plan when the spouse has access to coverage through their own employer.
What information must be reported on spousal surcharge - human?
Employees must report whether their spouse has access to health insurance coverage through their own employer.
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