Spousal/LDA Premium - FAQs
If your spouse or Legally Domiciled Adult (LDA) has access to medical coverage by another employer, or access to other offerings of medical insurance coverage, but you choose to enroll your spouse/LDA in Loyola's medical plan, you will be required to pay a spousal premium.
The spousal premium is a method adopted by many employers to help conserve plan cost(s).
- The spousal premium encourages participants who are eligible for other medical insurance coverage to take advantage of that coverage. This helps Loyola University Chicago share healthcare costs with other employers.
Due to the rising cost of health care, it is important that Loyola University Chicago provides faculty and staff members, including their families with the best possible health care coverage in a financially-responsible manner. One way we can do this is by creating an incentive for people to use the health plans from their own employers when it is an available option. Subsequently, this helps conserve costs to the University, which in turn helps the University keep our medical plans more affordable.
The spousal premium costs $100.00 per month ($23.07 per week/$1,199.64 per year).
The Loyola Medical Plans sponsored by Aetna are self-insured, and they pay the cost of each member’s medical coverage and actual claims.
- If your spouse/LDA moves to their employer’s plan, and uses that benefit, it saves Loyola the costs associated with those medical and prescription drug claims. In addition, Loyola's premium increases will be kept to a minimum.
The $100 monthly spousal premium applies to all active faculty and staff members whose spouse/LDA is a dependent on a Loyola University Chicago medical insurance plan UNLESS one of the following conditions applies:
- Your spouse/LDA is not presently employed, and they will not be employed any time after January 1 of the current year, and they do NOT have access to any other medical coverage through a previous employer;
- Your spouse/LDA is self-employed without access to other medical coverage;
- Your spouse/LDA’s other coverage is Medicare, Medicaid, TRICARE, or care received at a VA facility or other Military service coverage;
- Your spouse/LDA is covered under COBRA (continuation coverage);
- Your spouse/LDA loses their job-related health coverage.
(Note: The Insurance Marketplace, Medicare, Medicaid, Tricare, and COBRA are not considered other employer group health benefits.)
You will not be subject to the spousal premium. However, you must complete the Spousal/Legally Domiciled Adult (LDA) premium waiver during Open Enrollment each year.
If you decide to keep your spouse/LDA on your medical plan, the spousal premium would begin applying in the month they become eligible for their own coverage.
- You will need to contact Human Resources at firstname.lastname@example.org.
- This update will take effect the first pay period following the date your spouse/LDA becomes eligible for coverage with their new employer - or when the form is submitted to Human Resources for processing.
The University is committed to the highest ethical and professional standards of conduct as an integral part of its mission, the promotion of learning. To achieve this goal, the University relies on Faculty and Staff members ethical behavior, honesty, integrity and good judgement.
- We expect members of Loyola University Chicago to report honestly.
Any false statement would be considered a violation of our Code of Conduct, and could lead to disciplinary action leading up to and including termination, at the sole discretion of Loyola University Chicago.
Additionally, the consequences of a false statement, if discovered, are that you would lose all university contribution to your health premium.
- The $100 premium will be automatically assessed if you do not certify online through Employee-Self Service during annual Open Enrollment each year.
- This certification must be renewed each year during annual Open Enrollment in order to receive the reduced medical premium.
- Each faculty and staff member enrolled in one of Loyola's medical plans for January 1, will need to complete online annual Open Enrollment through Employee Self-Service, to certify or re-certify your Spousal Premium attestation each year.