YOUR MONEY-Family healthcare coverage demands new math

Reuters

By Beth Pinsker

NEW YORK, Oct 2 (Reuters) - Long Island publicist Brian Erniworks for a company that would extend health insurance to hiswife if he would pay for it. The problem: It costs $900 permonth to add her to his plan.

Families across the United States are facing similarsituations as many companies plan to trim, eliminate or chargeextra for benefits for employees' spouses in 2014, when keyparts of healthcare reform take effect.

Previously, a family might have bundled its health insuranceunder one adult's plan to save money. That is because individualinsurance rates on the open market tend to be high and payingthe single rate at two different companies may add up to morethan the family rate offered by most employers.

Now they will have to figure out the new math on how best tocover family members. It will often add up to sending spouses indifferent directions for coverage and sometimes to differentdoctors.

For slightly less than $400 a month, Enri's wife, LaurenBarresi, 26, can now sign up for a bronze-level plan with a$3,300 deductible, according to estimates on ValuePenguin.com.And a quote from private insurance marketplaceeHealthinsurance.com shows a comparable offering on the openmarket would cost more than $600, still less expensive than theemployer surcharge.

"The more difficult thing would be to keep track of who cango in for what - if somebody has strep throat, who canaffordably go to the doctor and who can't?" says Erni, 28, ofSt. James, New York.

About 33 percent of companies will add a surcharge forspousal coverage in 2014, according to a report from TowersWatson and the National Business Group on Health. About 5percent are unlikely to provide any subsidy at all to coverspouses.

Some 18 percent of companies, like United Parcel Service Inc, will only cover spouses who cannot get their ownworkplace plans. Others are no longer providing benefits tospouses at all, a move that Kroger Co just made for aselection of union workers in Indiana.

Before jumping into one big family plan, families should dosome comparison shopping. Here are some scenarios:

TWO WORKPLACE PLANS

For two working spouses, being on different plans might notbe that jarring if the offerings are fairly equal.

Financial planner Bryan Bly, 47, has done the math for thepast 11 years to see what arrangement is best for him and hiswife, 48 - and whose plan is better for their 9-year-olddaughter. Except for a brief time when his wife was betweenjobs, they have gone their own ways on medical coverage, but tojoin one or the other's dental and vision plans.

They did this even before Bly's employer in Atlanta begantwo years ago to put a surcharge on medical benefits for spouseswho are employed.

"The difference annually was in the hundreds of dollarsrange," Bly says.

If your employer makes this move to curtail family plans, beprepared to show documentation that your spouse is not otherwisecovered and that you are legally married. After initiating aspousal carve-out, Ball State University in Muncie, Indiana, isrequiring employees to produce copies of their marriage licensesand sign an affidavit in order to get spousal coverage.

ONE WORKER COVERED

For companies that are adding hefty surcharges or notcovering spouses at all, the uncovered spouse will have optionson the open market or on the new public health insuranceexchanges that opened on Tuesday.

A catch in the Affordable Care Act will disqualify thesespouses from subsidies because one member of their household hasa workplace plan. "They are referring to it as the familyglitch," says Bob Hurley, a senior vice president at eHealth,which runs eHealthinsurance.com. "I suspect policymakers willtake a look at this and remove this issue."

In the meantime, uncovered spouses can still get plans, justat full price.

"We think that spouses are going to have good options forcare through exchanges or through private insurance," saysBrigid Kelly, a spokeswoman for the United Food & CommercialWorkers International Union's Local 75, which representsKroger's workers in Indiana. While the government might notprovide any subsidies, she says the union has some funds to helpdefray the costs.

In Indianapolis, the unsubsidized bronze-level plans cost$250 to $300 a month, with deductibles that start at $4,300,according to insurance broker Nefouse & Associates, which isauthorized to sell policies on the state's public exchange.

SCANTY COVERAGE

If you are not happy with your workplace options, you can goout into the market and shop around, just without subsidies.While dependents are still covered under workplace plans up toage 26, families may consider getting them their own coverage,particularly if they are healthy young adults.

Maura Carley, chief executive officer of insuranceconsultancy Healthcare Navigation LLC, suggests comparingworkplace plans with public and private offerings.

"The world is really changing on Jan. 1," she says. "Youhave to know what your options are."

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