Tobacco and Spousal Surcharges

In addition to the medical plan premiums, benefits eligible employees may be subject to a tobacco use and/or a spouse or domestic partner coverage premium surcharge.

Note: Employees who have waived their WSU medical coverage are not required to complete a Surcharge Attestation form, since the tobacco/spouse coverage surcharges will not be applicable to them.

What Are the Premium Surcharges?

  • Tobacco Use Surcharge: If the employee or any covered family member uses tobacco products, a premium surcharge of $25 a month will be applied.Tobacco products include any product made with or derived from tobacco that is intended for human consumption, including any component, part or accessory of a tobacco product.  This includes, but is not limited to, cigars, cigarettes, chewing tobacco, snuff and other tobacco products.  It does not include FDA approved quit aids or e-cigarettes at this time.
  • Spouse or Domestic Partner Coverage Surcharge: For employees who enroll a spouse or domestic partner who has chosen not to enroll in their own employer-based group health coverage that has 1) benefits of at least 95% of the actuarial value of the Uniform Medical Plan (UMP) Classic, and/or 2) premiums less than 95% of the Uniform Medical Plan (UMP) Classic premiums, a premium surcharge of $50 a month will be applied.  A Spousal Plan Calculator is available to help employees determine the actuarial value of their spouse or domestic partner’s health plan.  The employee will need the Summary of Benefits and Coverage (SBC) for their spouse or partner’s offered employer-sponsored health plan(s) to determine the actuarial value of the health plan.

How Do I Address the Premium Surcharge?

ALL employees enrolled in a health care plan through employment at WSU MUST attest to the tobacco use and spouse or domestic partner premium surcharges.

New Employees: You will receive a benefits packet that includes the Employee Enrollment/Change form that addresses the surcharges.  This form must be completed and submitted to HRS within 31 days of your hire/eligibility date.

Employees Adding Newly Eligible Dependents: If you are adding a newly eligible dependent to your coverage, an Enrollment/Change form, which includes attestation information, must be completed and returned to HRS no later than 60 days after the event allowing you to make the plan change. Children under age 13 are not subject to the tobacco attestation.

Employees With a Change in Their Tobacco Use or Spouse Coverage Status:  If you or a covered family member have a change in tobacco use status, or if you cover your spouse and they have a change in their benefits status, a new Premium Surcharge Attestation form may be need to be completed.  Please contact Human Resource Services at (509)335-4521 or

What if I Don’t Address the Surcharges?

If an attestation is not received within 31 days of hire/eligibility date, or within 60 days of a special open enrollment event, the employee will incur the $25 tobacco use premium surcharge, and will also incur the $50 spouse or domestic partner premium surcharge if the employee has a spouse or domestic partner enrolled on their account.

Do you see a premium surcharge on your pay stub you don’t think is applicable to you?  Has your tobacco use or spouse coverage status changed?

If so, complete and submit a new Premium Surcharge Attestation form or contact HRS as soon as possible at (509) 335-4521.