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These provisions limit access to a plan when an employee's spouse works for another employer that offers health insurance. But before adopting such policies, employers should examine whether the savings will be sufficient to offset the administrative burdens and possible adverse employee reactions.

A spousal surcharge is an additional fee or premium that an employee is required to pay if his or her spouse has an alternative source for healthcare coverage through their own employer, yet elects to be added to the employee's plan.

Carve-out: A carve-out insurance plan is a supplement to a person's standard health insurance plan. The carve-out plan is provided by a third-party vendor, and it covers specialized care or products, such as prescription medications and treatment for chronic illnesses.

Yes. The spousal surcharge is considered a part of the employee's share of the health plan premium; accordingly, it qualifies for pre-tax savings with a POP. Q4 Can I offer payroll deductions to my employees and use the money to pay premiums for their individually-owned health insurance polices?

To avoid paying the surcharge, your spouse or partner can enroll in his or her employer's medical plan. You'll want to compare coverage and total costs both ways to see what makes sense for your family.

With a spousal surcharge program an employee must pay an additional cost to cover a working spouse who has the option to elect health coverage from his or her employer and has declined the coverage.

A spousal carve out is a health insurance plan design employers use to control health care costs by placing restrictions on coverage for an employee's spouse. Another term used for this type of plan design is the "working spouse rule." Employers commonly use several spousal carve out design variations.