What are mono-parental and couple rates?

Before we can cover mono-parental and couple rates it is important to understand the family status options available on the majority of benefit plans. For benefits such as EHB and Dental, an option is given to the employees regarding whether or not they will waive the benefit entirely or opt for single or family coverage. Here is a quick summary of what these three options entail:

Waived – the employee opts not to participate in this particular benefit. This is typically due to coverage being available through an alternate plan, most commonly their partner’s plan. Note that if this is the case, the employee should only waive coverages that they have elsewhere, such as EHB and Dental. They should not waive all coverages (in effect opting not to join the plan) as this will leave them without key benefits such as Life, AD&D, LTD and critical illness. Waiving all coverage may cause issues if the employee later opts to join the plan. Full medical underwriting will likely be required.

Single coverage – coverage only applies to the employee. No claims can be made by any other dependant. Single coverage has a lower rate, as the risk exposure is significantly less and it is clear exactly how many people are being covered (one).

Family coverage – coverage applies to the employee and all eligible dependants. The definition of eligible dependants differs from carrier to carrier, but in general it covers one spouse and an unlimited number of children, provided they are under a pre-determined age (most commonly 22) and remain dependant on their parents. Children that study full time may be covered past the age limit. The number of dependants covered via each employee will change over time, as young families have children or the children of older couples become ineligible. The number of dependants doesn’t effect the rate that each employee pays, all employees with family coverage in the same class will pay the same family rate.

It is the catch all nature of the family status that led to the creation of mono-parental and couple rates. These options are typically not included unless requested. Note that one or both of these can be added, meaning you could opt to add couple rates but leave single parents in the family class. Because family rates can cover any number of dependants they are typically more than twice the single rates. Couple and mono-parental rates sit somewhere between the single rates and family rates.

These statuses are somewhat self explanatory but here’s a quick overview of what they cover:

Couple coverage – this coverage is for two adults without children.

Mono-parental coverage – this coverage is for a single parent with any number of dependant children.

Risks & other considerations

Having additional family statuses does create more administration as employees have more statuses to move between. For small groups it can also make the plan more complicated and spread the experience out amongst more groupings. For this reason these additional statuses may not be available, depending on the size of the group and the carriers quoting.