Working Spouse Rule

Starting with the 2026 plan year, spouses of OSU/A&M benefits-eligible employees who are employed and have access to group health coverage through their own employer will no longer be eligible for coverage under the OSU/A&M medical plan. 

 

This practice, commonly called a “working spouse rule” by employers, is part of our ongoing efforts to manage rising healthcare costs while continuing to offer high-quality and cost-effective medical coverage to system employees.

 

Spouses without access to group coverage will remain eligible for coverage.    

 

 

Frequently Asked Questions

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• Are all spouses excluded from the OSU/A&M employee health plan?

  No. Coverage is still available for spouses who do not have access to coverage through an employer group health plan. This includes:

  • • • Spouses who are not employed outside of the home 
      • Spouses who are not eligible for group medical coverage through their employer
      • Spouses who are in a coverage “waiting period” with their employer, once the waiting period ends the rule applies 
      • Spouses who work for an employer who does not offer group medical coverage 
      • Spouses who are on Medicare and do not have access to employer group medical coverage 
      • Spouses who are retired and no longer have employer group medical coverage
• What qualifies as a group employer health plan?

  Any Affordable Care Act qualifying medical plan provided by your spouse's employer to its employees. 

• What if my spouse is self-employed?

  A self-employed spouse is considered to have access to employer group health coverage if their business provides an Affordable Care Act (ACA) qualifying group health plan to employees, including themselves.

   

  If your self-employed spouse does not maintain a group health plan and instead relies on individual coverage, such as through the Health Insurance Marketplace, they remain eligible for coverage under the OSU/A&M medical plan.

• What does “access to employer group health coverage” mean?

  A spouse is considered to have access if their employer offers an Affordable Care Act (ACA) qualifying group medical plan, even if the spouse chooses not to enroll. Cost or plan design differences compared to OSU/A&M’s plan do not affect this rule.

• Can I still enroll my spouse in voluntary benefits?

  Yes, your spouse is still eligible to participate in offerings including dental, vision, MASA and supplemental life insurance. 

• What if my spouse and I are both OSU or A&M employees?

  During Annual Enrollment, you should both choose employee only coverage. If you have dependents, one of you should select employee and dependent coverage. 

• What if my spouse is an OSU/A&M student, undergraduate or graduate student, or holds a GRA/GTA paid position?

  Spouses who are students at an OSU/A&M institution remain eligible for coverage under the OSU/A&M medical plan because the student health insurance program is not considered an employer-sponsored group health plan. 

   

  If the spouse holds a Graduate Research or Teaching Assistant (GRA/GTA) paid position, the GRA/GTA United Healthcare Plan is an ACA-eligible plan, but not considered an employer-sponsored group health plan. Because GRA/GTAs are automatically enrolled in UHC coverage each semester, the spouse must actively waive the GRA/GTA coverage.

   

  International students are required to remain on the student health plan. To request an exception, the spouse would need to submit a waiver request to International Students & Scholars (ISS) for consideration. If the waiver is not approved, they cannot be added to the OSU/A&M employee medical plan as a spouse.

• How is “spouse” defined under the working spouse rule?

  For purposes of the OSU/A&M working spouse rule, a spouse is a person who is legally married to an OSU/A&M benefits-eligible employee. This includes both opposite-sex and same-sex marriages that are legally recognized.

   

  Common law spouses are included if the relationship meets the requirements of Oklahoma law (or the state in which the common law marriage was established) and the required documentation is provided during dependent verification.

   

  Domestic partners who are not legally married are not considered spouses under this rule.

• Can I use my FSA or HSA funds for my spouse’s expenses if they are not covered under the OSU/A&M medical plan?
  Yes. IRS rules allow you to use FSA and HSA funds for eligible medical expenses incurred by your spouse, even if they are not enrolled in the OSU/A&M medical plan. The working spouse rule only impacts eligibility for coverage under the OSU/A&M medical plan - it does not change who qualifies as an eligible dependent for FSA or HSA purposes.
• What if my spouse works remotely for a company located out of state?

  Under OSU/A&M’s working spouse rule, if your spouse’s employer offers an Affordable Care Act–qualifying group medical plan, they are considered to have access and would not be eligible for the OSU/A&M medical plan. If no group plan is offered, they remain eligible.

   

  Note:  Many employer health plans, especially those through national insurers like Blue Cross Blue Shield, provide nationwide in-network access, even if the plan is issued in another state. We encourage the spouse to contact their employer’s HR or benefits office to confirm coverage options while living in Oklahoma.

• My spouse's employer holds Annual Enrollment at a different time than OSU/A&M, what should we do?

  The plan year for some employer plans might differ from OSU/A&M's, which is based on the calendar year. However, the implementation of this change is considered a qualifying life event, allowing your spouse 30 days to make a plan change, such as enrollment in their group health plan.  

• What happens if my spouse loses their employer coverage mid-year?

  Loss of employer group coverage is a qualifying life event. You will have 30 days to add your spouse to the OSU/A&M plan.

• How will the rule be verified?

  Each year, employees covering a spouse will be required to complete a spousal eligibility attestation during Annual Enrollment. Proof of coverage or lack of coverage may be requested.

• Will I be required to complete a spousal eligibility attestation if I am not married or not covering a spouse?

  Yes. During the Annual Enrollment process, you will see a pop-up survey question asking if you are married.

   

   If you answer “yes,” you will then be asked whether your spouse has access to other employer group health coverage.

  If you answer “no,” you will simply continue through the enrollment process without needing to provide any additional verification.

• What happens if I don't fill out the attestation?

  Your spouse's coverage under the OSU/A&M employee plan will end on 12/31 and will not be renewed unless a qualifying event occurs.

• Does this rule apply to children or other dependents?

  No. This change only applies to spouses. Children and other eligible dependents are not affected.