Cincinnati Children’s modifies spousal health coverage

Cincinnati Children’s is updating eligibility for spousal medical coverage, a spokesperson confirmed to Becker’s.

The nonprofit pediatric health system cited rising costs to provide coverage in its announcement about the change.

“To help keep our plans affordable, we are updating eligibility for spousal medical coverage,” the spokesperson said. “Spouses who have access to group medical coverage will be required to enroll in their own employer’s coverage and will no longer be eligible for our medical plans.” 

The change comes as healthcare leaders are frequently evaluating benefits to ensure they align with employee preferences and today’s healthcare environment. Becker’s recently asked executives to share how they have adjusted their benefits with this goal in mind. They referenced strategies ranging from expanding free health coaching to a new low-deductible health plan.

At Cincinnati Children’s, the spousal coverage change will be effective Jan. 1 for new hires and newly eligible employees and July 1 for current eligible employees. 

Spouses will remain eligible for a Cincinnati Children’s health plan if they are unemployed; are ineligible for medical benefits through their employer’s plan; are eligible only for Medicare; have access only to retiree coverage, individual plans, Medicaid, Marketplace/Exchange plans, or HSA/HRA-only plans, the organization said. Spouses will also remain eligible for a Cincinnati Children’s health plan if they are not offered a plan through their employer that is minimum essential coverage (as defined by the ACA) or affordable (calculated monthly premium is more than $200 for the most affordable plan available).

The health system said it is offering one-time payments to those affected to ease the transition. Cincinnati Children’s employees whose spouse will lose their Cincinnati Children’s coverage on July 1 will receive a payment of $1,500. Employees will receive an additional $500 if their spouse disenrolls from their Cincinnati Children’s plan by Jan. 1.

“As a self-insured employer, any expense management changes we make to our plans help to keep employee costs down as well,” the health system said. “We regularly review our benefits to support our employees’ health and well-being while managing resources responsibly so we can continue to fulfill our mission and care for the patients and families depending on us.” 

The post Cincinnati Children’s modifies spousal health coverage appeared first on Becker’s Hospital Review | Healthcare News & Analysis.