Dependent Coverage

Dependent coverage is health coverage for an employee's family members, most commonly a spouse and children. Under the Affordable Care Act, a plan that covers children must allow them to stay on until age 26, regardless of whether they're married, in school, or living at home.

The cost of dependents is where family budgets get squeezed. An employer might charge an employee $120 a month for single coverage and $850 for family coverage, because the employer contribution for dependents is usually smaller. Some employers add a spousal surcharge of $50 to $150 a month when the spouse has coverage available through their own job, and a few decline to cover working spouses at all. Eligibility audits have become common: employers ask for marriage and birth certificates and remove dependents who don't qualify, which typically trims 3 to 8 percent of covered dependents. For a couple where both work, it's worth running the math on each spouse covering themselves versus one family plan.

The takeaway: price out dependents carefully at open enrollment. Two single plans at two employers, or a child on a marketplace plan with a subsidy, can beat one family plan by hundreds of dollars a month.