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Timing is a key component when adding a spouse to your health insurance policy. If you carry coverage through your employer, adding a spouse wholly depends on the type of coverage offered. While most companies do offer health insurance coverage to employees, they are not under any legal obligation to extend benefits to spouses or children.

Understanding the terms of your policy is paramount. If your company-sponsored health plan offers an “employee and spouse” option, then it is possible to extend coverage to a spouse.

If You’re Already Married

At the time you enroll yourself in a healthcare plan, you may also elect to cover your spouse. Keep in mind that “employee and spouse” coverage will cost you more than the “employee only” option.

This is the time to exercise due diligence. If your spouse is also employed and has current coverage with his or her employer, do a cost comparison. Would adding them to your plan save your family money? The cost may actually be less if you each keep individual policies. Does your plan offer a wider range of benefits?

Once you decide to add a spouse, you usually need specific documentation to prove eligibility. You may need a copy of your most recent federal tax return (obliterate financial information), your marriage certificate, and proof of joint ownership. This is either a mortgage or bank statement, property tax bill, or a lease agreement. It is likely that you will need these documents no matter when you add a spouse to your coverage.

If You’re About To Get Married

If you marry after you enroll in the plan, you have a limited amount of time to notify the insurance carrier about your change in marital status, and your desire to add your spouse. Be certain to check with your HR manager and your company’s insurance carrier so you don’t miss important deadlines. Allow enough time to get and complete the required enrollment forms.

Open enrollment is a period of time each year, determined by the company that sponsors your work-based healthcare plan, during which you may sign up for coverage, add additional coverage, or change carriers. Most large companies offer the open enrollment option in the fall so that the coverage will begin at the start of the calendar year.

Qualified applicants who apply during this period are not subject to underwriting restrictions. If you wish to add a spouse to your policy, make sure you know the open enrollment dates, and plan accordingly.

When The Unexpected Happens

You may also add a spouse to your policy if you show proof of a “qualifying event”. In the case of health insurance, this would be the loss of spouse’s employer-sponsored coverage. This could be either because they lost the job, or because a reduction in work hours made them ineligible. Electing to terminate coverage or failure to pay the premium does not qualify for the special circumstance or as a qualifying event.

What About Removing A Spouse From Your Health Insurance Policy?

Removing a spouse from your health insurance plan has time sensitive requirements as well. You may change your coverage from “employee and spouse” to “employee only” during the stated open enrollment period. If the change is because your spouse wishes to enroll in his or her own company’s plan, be certain the open enrollment times for both businesses coincide.

Death or divorce would both be “qualifying life events’ and terminating spousal coverage can take place outside of the open enrollment period.

Adding a spouse your health insurance (or removing one, for that matter) requires spot-on timing and professional expertise. If you’re a business owner, partnering with a trusted team of experts in the insurance industry will give you and your employees peace of mind and the tools to do things right.