Why are couples forced onto "family" health insurance plans and pay the same premiums as those with children?

  • by Tom
  • Dec 29,2018
  • 6 answers

Why are couples forced onto "family" health insurance plans and pay the same premiums as those with children? (This is with regard to plans provided through employers. Also, I understand couples can theoretically each get their own insurance if they are both working; the scenario at hand is if one spouse is not working.)


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Insurance Answers (6)

Flower 3 weeks ago

If your employer plan is too expensive, perhaps a marketplace plan would be better for you. A spouse and children can be covered by either spousal insurance.

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Oldwhiteguy2earth 3 weeks ago

A couple is a family.

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A Hunch 3 weeks ago

They aren't.
Plans purchased directly from insurance are purchased based on the number of adults.
Most employer based plans are either employee + 1 or employee + spouse.
- very rarely union based plans will be employee or family.

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Insurance Pickle.com 3 weeks ago

That's not a thing. There is employee, employee plus spouse, employee plus child(ren), and 2-parent family. What you described doesn't exist. But, that does not keep an employer from changing the contribution levels at the employer level to make it look that way. But, that would be a question for your employer. It's otherwise just not something that's out there.
Also, in the small group market, the total cost is just a sum of the individuals' rates. That is to say that a 5-person family is the combination of rates of the 5 individuals. Only large group averages rates for the group (at least in the states I do business in).

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y 3 weeks ago

This is with regard to plans provided through employers
The plans are not the same employer to employer. So what may be true for you, is not for everyone. Why an insurance company would want it to be that way would be to off set cost. Why an employer would want it that way would be to attract a family orientated person, by keeping their cost down.

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curtisports2 3 weeks ago

In most states, they aren't. Several years ago, something called the 'self plus one' plan was created to cut costs for couples who never had children or whose children were grown. Most national plans have this and the state doesn't matter.

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