Additional Costs for Medical Coverage

There are two additional costs for medical coverage that medical plan participants and/or their covered spouses could incur: working-spouse surcharge and tobacco-user surcharge.

Working-Spouse Surcharge

During benefits enrollment, you will be asked to attest electronically to whether your spouse has access to a group medical plan through his/her employer.

A BJC employee whose spouse is eligible for his/her employer’s group medical coverage, but chooses to cover his/her spouse under BJC’s Medical Plan, will pay an additional $50 per pay period toward the spouse’s medical coverage. This is called the “Working-Spouse Surcharge.”

The Working-Spouse Surcharge will not apply if:

  • You do not have a spouse, or you do not plan to enroll your spouse in BJC medical coverage.
  • Your spouse is not employed, or your spouse is not employed and has access to medical coverage in a government-sponsored medical plan, such as Medicare, Medicaid or Tricare, or through a retiree medical plan from his/her former employer.
  • Your spouse is employed, but not eligible for his/her employer’s group medical plan.
  • Your spouse is self-employed and is not eligible for group medical coverage.
  • Your spouse is employed by a BJC HealthCare organization.

Tobacco-User Surcharge

During benefits enrollment, you will be asked to verify your and your spouse’s use of tobacco. If you or your covered spouse attest to using tobacco, you will pay a “Tobacco-User Surcharge” of $25 per person, per pay period beginning in May 2021, in addition to the costs you will pay toward your 2021 BJC Medical Plan coverage unless you and/or your spouse complete the Quit for Life tobacco-cessation program between September 1, 2020 and March 31, 2021.

Because completion of the program requires five weekly calls with your Quit Coach, enroll in Quit for Life by February 1, 2021 in order to meet the March 31, 2021 deadline requirement.

Call 866.784.8454 or go to to get started.

The Tobacco-User Surcharge for 2021 only applies to employees who are actively covered in the BJC Medical Plan on January 1, 2021.