Spousal surcharge when spouse’s employer’s network is in another region

I posted this in r/Insurance and didn’t get much response, so please pardon the cross-post.

I work at a company that charges a “spousal surcharge” for health insurance.

If I alone use my company’s health insurance, there is no surcharge, and I just pay the premium. However, if I also want to bring on my spouse and if her company offers health insurance, I not only pay her premium as well, but a very large surcharge. (The surcharge is substantially higher than the actual combined premiums, and is 3x the largest such surcharges I’ve seen others discussing on Reddit.)

The rub is that my wife’s company does offer insurance, but through a regional network: the nearest in-network physicians and facilities are hundreds of miles away. This means that she would have no de facto insurance network where we live, and the only real option would be using the insurance provided through my company.

I have a few questions:

Does my company just pocket his spousal surcharge money? Or does the insurance company get it? Since hitting me with this surcharge doesn’t seem to fit the spirit of the rule because my spouse doesn’t have any realistic insurance options through her employer, is there a way to get around this?

I am in Missouri.

submitted by /u/Kodiak-Marmoset
[link] [comments]I posted this in r/Insurance and didn’t get much response, so please pardon the cross-post. I work at a company that charges a “spousal surcharge” for health insurance. If I alone use my company’s health insurance, there is no surcharge, and I just pay the premium. However, if I also want to bring on my spouse and if her company offers health insurance, I not only pay her premium as well, but a very large surcharge. (The surcharge is substantially higher than the actual combined premiums, and is 3x the largest such surcharges I’ve seen others discussing on Reddit.) The rub is that my wife’s company does offer insurance, but through a regional network: the nearest in-network physicians and facilities are hundreds of miles away. This means that she would have no de facto insurance network where we live, and the only real option would be using the insurance provided through my company. I have a few questions: Does my company just pocket his spousal surcharge money? Or does the insurance company get it? Since hitting me with this surcharge doesn’t seem to fit the spirit of the rule because my spouse doesn’t have any realistic insurance options through her employer, is there a way to get around this? I am in Missouri. submitted by /u/Kodiak-Marmoset [link] [comments]Read Morer/HealthInsurance

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