Find Out if Your Spouse Is Eligible for UVA Coverage

Affordability Standard Calculator

If your spouse has access to health benefits through their employer, they are not eligible for coverage as a dependent on the UVA Health Plan if that coverage meets the Affordable Care Act's affordability and minimum value standards, which means their employer offers health coverage that meets federal requirements for both cost and level of benefits.

There are two exceptions:

  • If your spouse’s employer offers affordable health coverage that provides minimum value but ALL of the employer’s health options are HMOs and your spouse lives outside the HMOs’ defined service areas, then your spouse is eligible to be a dependent on your UVA health plans.
    • In this case, documentation from your spouse’s employer is required and can be uploaded as an attachment in the View Summary (electronic signature) page of your benefit event in the Attachments section. 
  • If spouses both work at UVA or UVA Medical Center in a benefits-eligible position, then either spouse is eligible to be a dependent on the other's UVA health coverage.
    • You may not add a health benefits-eligible UPG spouse to your UVA health coverage. 

Affordability Standard Calculator

Use the following calculator to help determine if employer-based coverage meets the affordability standard as derived from the federal Affordable Care Act. Employer-based coverage is considered "affordable" if it does not exceed 10.22% of the employee's income:

 
 
 

Notes

  • The affordability standard calculator only determines if your spouse’s coverage meets the affordability standard. Check with your spouse’s employer to determine if their employer-sponsored coverage meets the minimum value standard. If either the affordability standard OR the minimum value standard is not met, your spouse is eligible for coverage on the UVA Health Plan.
  • If your spouse does not currently have access to affordable employer sponsored health coverage but later gains it, this is a qualified life event, and your spouse loses eligibility to remain covered on our Plans beyond the end of the month in which other coverage is gained. You are required to drop your spouse within 60 days of the qualified life event by changing your benefit elections in Workday and uploading any required documentation.
    • Any false statements provided by you relating to spousal health information shall be considered grounds for disciplinary action. The Summary Plan Descriptions contain additional information regarding other possible penalties for insurance fraud.