Premier Health dropping health insurance for working spouses


Premier Health next year will drop health insurance coverage of employees’ spouses who are eligible for insurance through their employers, said Diane Ewing, spokeswoman for the health system.

Premier Health will continue to cover spouses who do not have access to a health plan, Ewing said.

“Just as we are seeing with other businesses, we want our employees and their family members to be covered, but also need to be mindful of rising costs to do so as this impacts our overall employee population,” Ewing said in a statement.

“This approach does have the potential to lower our costs, while still being assured that there is an option for coverage for those spouses who can access their employer’s plan,” she said.

As a result, Premier Health expects the number of people it covers on its health plan to drop, but declined to estimate by how much. Premier has more than 14,000 employees.

Other companies excluding working spouses from coverage include package delivery company United Parcel Service Inc., impacting local UPS workers in West Carrollton and Sharonville.

This newspaper first reported Monday that health systems Kettering Health Network and Premier Health were making changes to their health insurance coverage during annual open enrollment time.

Kettering Health, which employs about 10,000, is not changing health insurance coverage of spouses, spokeswoman Elizabeth Long said.

Both systems are self-insured, paying for their employee medical claims. The nonprofit hospital and doctor groups use third party administrators that process employee claims and establish a network of providers.

The systems are changing insurance companies that process claims effective Jan. 1, 2014.

Along with changing outside claims processors, the systems are introducing new wellness incentives to promote healthier employee behavior.

Nearly 40 percent of employers anticipate making changes to their health plans for 2014 due to the increase in employee health care costs, according to benefits consultant Towers Watson.

One area employers are focusing on is coverage for spouses and dependents.

Nationwide, 20 percent of nearly 600 large employers in a survey completed earlier this year charged a spousal surcharge on premiums in 2013. An additional 13 percent plan to do so next year, according to the study, which was conducted by Towers Watson and the nonprofit National Business Group on Health.

The study also found that 4 percent of companies excluded spouses from their health plans when similar coverage was available through the spouse’s employer. And another 8 percent planned to do so next year.

“Companies are facing rising health care costs and must make some tough decisions in light of that reality,” said James Haubrock, shareholder and chairman of employee benefit plan services, for regional public accounting firm Clark Schaefer Hackett.

“They have to balance their desire to manage costs, their need to attract and retain a high-quality labor force, and the requirement to comply with the (Affordable Care Act). Some employers will see eliminating coverage for spouses as a viable option to meet those competing needs,” Haubrock said.

The federal Patient Protection and Affordable Care Act does not require employers to cover spouses or domestic partners, Haubrock said.

Kettering Health operates the hospitals Fort Hamilton, Grandview, Greene, Kettering Medical, Kettering Behavioral, Soin, Southview and Sycamore. Premier includes the hospitals Atrium, Good Samaritan, Miami Valley and Upper Valley.

The Associated Press contributed to this report



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