2016 Trend - Continued Adoption of Working Spouse Provisions

As widely predicted, the adoption of working spouse provisions is continuing to climb. A study by PwC (Health and Well-being Touchstone Survey Results) found a slight decline (1%) in the adoption of exclusion rules (carve-outs) but a sharp increase in the adoption of spousal surcharges. Large employers, those with over 5,000 active employees, are most likely to have a spousal surcharge (31%), while mid-sized (18%) and smaller employers (11%) still exhibited increased adoption. This trend is expected to continue in 2016, with 40% of employers planning to implement some version of a working spouse provision in the next two years.

In order to achieve the maximum cost savings from these programs, employers need to verify the availability of other coverage with the spouse’s employer. On average, we find this approach yields 25-30% participation in the rule, resulting in 300% more cost savings than the affidavit approach (8-10% participation on average).