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How does my family size affect my employer contribution?

Your employer contribution is based on who you enroll in medical coverage, not just who is on your profile.

It depends on your employer and on who you enroll. Your employer sets a monthly contribution for you, and many employers add more for a spouse and/or children. Those extra amounts only apply to family members you actually enroll in a medical plan. If your spouse is on your profile but isn't enrolling, you won't receive the spouse portion.

How your contribution is calculated

Your total employer contribution is your amount plus any amount your employer offers for the family members you enroll.

  • You: Your employer sets your amount. It may vary based on things like your age, where you live, or your job classification.
  • Spouse: Some employers add an amount when you enroll your spouse. Others don't.
  • Children: Some employers add an amount for each child you enroll. Some limit how many children count, or cap the total amount for dependents.
  • Domestic partner: Only counts if your employer's plan allows it.

Children under 26 and legal wards can count toward your contribution.

Example

Say your employer offers $500/month for you, $300/month for a spouse, and $200/month per child. (Your employer's amounts and rules may be different.)

  • Just you: $500/month
  • You and your spouse: $800/month
  • You and two children: $900/month
  • You, your spouse, and two children: $1,300/month

If your spouse and two children are on your profile but you only enroll yourself and the children, your contribution is $900/month, not $1,300/month.

Where to see your amount

When you choose who is included in your medical plan (use the "participants" filter when shopping), your employer contribution updates as you check or uncheck family members. The plan prices you see while shopping already include your contribution.

Good to know

  • If your plan costs less than your contribution, you pay $0 for your premium. The unused amount stays with your employer. It doesn't roll over and isn't paid out to you.
  • If you add or remove a family member during the year because of a qualifying life event, your contribution may change.
  • For questions about your employer's specific amounts, contact your HR team or support@benefitbay.com.