Spousal Plan

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

Reimbursements include:

• Deductibles
• Copays
• Coinsurance
• Prescriptions
• The difference between the alternate plan’s monthly premium contribution and ARUP’s monthly medical insurance rates if the alternate plan’s premiums are higher

The SPLAN is equivalent to $110 for an individual, $195 for two people, or $270 for the whole family (based on full-time employment rates).

How it works:

1. Present the provider with your spouse’s insurance ID card or your alternate employer's 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 any of the following apply:

• Your spouse is not employed.
• Your spouse does not have access to an employer-provided health benefit plan.
• You are receiving or contributing to a health savings account (HSA).
• The alternate plan is a Medicare, Retiree Tricare, or an individual plan.

Premium Equivalent

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)