Kewaunee County officials are considering the implementation of a spousal surcharge and nicotine surcharge as part of their health insurance plan, a move that could significantly impact county employees and their families. During the Finance Meeting on April 4, 2025, discussions centered around the potential financial implications of these surcharges, with a focus on how they might affect overall healthcare costs for the county.

The conversation highlighted the common practice in the private sector of requiring employees to verify whether their spouses have access to other insurance. This verification process could lead to a spousal surcharge if implemented, which would require employees to attest to their spouse's insurance status. The county's insurance consultant noted that nicotine users typically incur higher medical costs, averaging $5,500 more annually compared to non-users, making the nicotine surcharge a more straightforward consideration.

However, the discussion revealed complexities surrounding the spousal surcharge. While it could potentially reduce costs by limiting coverage for high-utilizing spouses, the financial benefits are not as clear-cut. Officials expressed concerns about how forthcoming employees would be with the required information and the risk of losing participants from the insurance plan altogether.

To better inform their decision, county officials agreed to gather more data on the financial impact of these surcharges, both locally and statewide. They acknowledged the limitations of relying on small sample sizes for predictive analysis, emphasizing the need for a broader understanding of the potential outcomes.

As the county prepares for further discussions in August, the implications of these proposed changes remain significant, with potential effects on employee satisfaction and overall healthcare costs. The outcome of this initiative could reshape how Kewaunee County manages its health insurance offerings in the future.