Archive: Spousal Plan - 2020

NBS

The ARUP Spousal Plan (SPLAN) is a medical expense reimbursement program. ARUP will provide reimbursement when enrolled in an alternate health plan through a spouse or another employer and opt-out of ARUP’s medical benefit plan.

Reimbursements include:

  • Deductibles
  • Co-pays
  • Co-insurance
  • Prescriptions
  • The difference between the alternate plan’s monthly premium contribution and

$104 (individual) $187 (2 party) $260 (family) *full time rates

National Benefits Services
8523 South Redwood Road
West Jordan, Utah 84088
(801) 532-4000
(800) 274-0503
Fax: (800) 478-1528
www.nbsbenefits.com

Plan Information

How it works:

  1. Present the provider with your spouse’s (or alternate) insurance ID card
  2. You will receive an Explanation of Benefits (EOB) from the alternate insurance once the claim is processed
  3. Submit the EOB to our claims administrator, National Benefit Services (NBS)
  4. Your portion of the eligible expenses will be paid by ARUP

You do not qualify if:

  • Your spouse is not employed
  • Your spouse does not have access to an employer provider health benefit plan
  • If you are receiving or contributing to an Health Savings Account (HSA)
  • If the alternate plan is a Medicare or Retiree Tricare or an individual plan
Premium Equivalent

Premium Equivalent

2021

Full Time
30+ Hours/Week
Part Time
20-29 Hours/Week
Reimbursement Cap

ARUP Group Medical Premium Equivalents

Employee Only $104 $146 $250
Spouse Only $104 $146 $250
Employee + 1 Child $187 $270 $500
Employee + Spouse $187 $270 $500
Spouse + 1 Child $187 $270 $500
Employee + Children $260 $385 $500
Spouse + children $260 $385 $750
Employee + Family $260 $385 $750

Premium Difference calculation = (Alternate Qualified Health Plan premium (A) – ARUP Group Medical premium equivalent (B))

A _______________ - B __________________ = ___________________ (must be greater than zero to receive reimbursement)

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