Seeking Superior Solutions with a Spouse’s Employer’s Plan

In many cases, the readily available option isn’t always the best. When a spouse’s employer offers better coverage, out-of-pocket costs can be greatly reduced.

The Opportunity

An employee re-entered the workforce at a local school. This employee’s family enjoyed the low premiums of the employer’s group plan, but the out-of-pocket costs were another story.

With an out-of-pocket maximum of $16,000, the employee’s MS injections were quick to eat into the family’s finances (billing $7,500 every three weeks). What’s more, the previous year’s claims had cost the client’s plan upwards of $130,000.


Digging deeper, our Executive Resource Specialist found a viable alternative: the spouse’s employer, who offered a family plan.

Being a PPO plan, this came with higher premium deductions — but a considerably lower deductible, out-of-pocket maximum and manageable copays. With a cost comparison we put together, the family was able to make an educated choice on which plan to choose: the spouse’s employer-sponsored plan was cheaper for the annual, total spend.


Though seemingly more expensive when only comparing premium deductions, the family quickly broke even (and started saving) by leveraging this alternative option. As they hit the family out-of-pocket maximum every year with MS treatments, using the spouse’s employer-sponsored plan was an overall better fit.

The Benefit Resource Genie™ exists to unlock better options for your people — and to reduce your costs in the process.

Benefit Resource Genie TM doesn’t guarantee the savings achieved in this case.