Loyola University Chicago

Human Resources

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. Subsequently, this helps Loyola University Chicago share healthcare costs with other employers, which in turn helps the University keep our medical plans more affordable.
Beginning January 1, 2018, the spousal premium will cost $100.00 per month ($23.07 per week/$1,199.64 per year).
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.
The Loyola University Medical Plans sponsored by Blue Cross Blue Shield of Illinois are self-insured, and they pay the cost of each member’s medical coverage and actual claims. 
  • If your spouse moves to his/her 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. 

No. The spousal premium only applies to Spouses and Legally Domiciled Adults.

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, 2018, 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, and Tricare are not considered other employer group health benefits)
 

If your spouse is covered by Medicare, and he or she is eligible for other group coverage (i.e. through a different employer), you will be subject to the $100.00 spousal premium.

  • Has access to health plan coverage, but it is more expensive than Loyola’s plans, and/or
  • Less comparable plan designs?

If your spouse enrolls in a Loyola University medical plan, the working spouse premium will apply in each of these situations.

No. COBRA coverage does not constitute an employer-sponsored medical plan. In this instance, your spouse/LDA no longer qualifies for employer-sponsored medical coverage, and you will not be subject to the spousal premium. 
  • You must notify Loyola's Human Resources office within 31 days of the qualifying event to make benefit changes.
Since your spouse/LDA is not eligible for medical coverage through their former employer at this time, the spousal premium would not apply. You will need to submit a spousal waiver form to Human Resources.

You will not be subject to the spousal premium. However, you must complete the 2018 Spousal/Legally Domiciled Adult (LDA) Surcharge Waiver Form.

If you decide to keep your spouse/LDA on your medical plan, the spousal premium would begin applying in the month he/she becomes eligible for their own coverage. 

  • You will need to submit a new 2018 Spouse/LDA Surcharge Waiver Form. 
  • 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. 
This is a qualifying life event, and your spouse/LDA would be eligible to enroll in a Loyola University Chicago's medical plan. 
  • The spousal premium would not apply to you. 
  • You will need to report your qualified life event within 31 days from the effective date of your spouse/LDA losing his/her coverage.

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 enrollment,  November 1 - 22.
  • 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 the Loyola Medical Plan for 01/01/2018, will need to complete online annual open enrollment through Employee Self-Service, November 1- 22, to certify or re-certify your spousal premium attestation, and tobacco use premium attestation for 01/01/2018.

Each faculty and staff member enrolled in the Loyola Medical Plan for 01/01/2018, will need to complete online annual open enrollment through Employee Self-Service, November 1- 22, to certify or re-certify your spousal premium attestation, and tobacco use premium attestation for 01/01/2018.

  • The $100 premium will be automatically assessed if you do not certify online through Employee-Self Service during annual enrollment  November 1 - 22.
  • 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 the Loyola Medical Plan for 01/01/2018, will need to complete online annual open enrollment through Employee Self-Service, November 1- 22, to certify or re-certify your spousal premium attestation, and tobacco use premium attestation for 01/01/2018.

  • The $100 premium will be automatically assessed if you do not certify online through Employee-Self Service during annual enrollment  November 1 - 22.
  • This certification must be renewed each year during annual open enrollment in order to receive the reduced medical premium.

If you have additional questions regarding the spousal/LDA premium, please send an email to benefits@luc.edu.