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Council hears staff proposal to stop adding Medicare‑eligible spouses to new hires' city health plan; legal questions raised
Summary
Staff proposed adding a 'spousal carve‑out' to the personnel handbook so spouses on Medicare would not be enrolled in city coverage for new employees; a council member warned that excluding Medicare‑eligible spouses may raise legal issues and staff agreed to seek clarification from benefits consultants.
Staff described a proposed personnel handbook amendment to implement a spousal carve‑out for new employees: if a spouse is on Medicare, staff would not add that spouse to city coverage going forward; current employees with spouses on city coverage would be grandfathered and remain on the plan.
"The spousal carve out policy is simply eligible for Medicare, they need to be on Medicare, and they will not be on our policy," staff member Mandy said, explaining the rule would apply to new hires at the policy renewal on Sept. 1. Council member S9 disputed the legal basis for excluding coverage for Medicare‑eligible spouses, warning, "I don't believe you legally can keep a spouse off the plan if they're eligible for Medicare. You can get in trouble with Medicare or with the government." Staff committed to check with Apex Benefits and HR consultants and to clarify the policy language before any council action. The council did not adopt the handbook change at the meeting; staff said they would return with legal clarification.
