Employees may ask whether their spouse and children can join. Decide four things before you sign: whether dependents can enroll, who pays for them, what they cost, and how they show up on the invoice. Families can be a good part of an employer contract if those answers are clear.
Can dependents join?
Some contracts cover employees only. Others let spouses and children enroll. If dependents can join, define who counts: spouse, domestic partner, children up to what age. Use the same definitions as the employer's health plan where you can, so employees aren't confused.
Who pays?
- The employer pays for everyone.
- The employer pays for employees, and employees pay for dependents.
- Dependents join at your regular individual price, paid by the employee.
If employees pay part, decide whether they pay you directly or through the employer. This post covers split payments.
Pricing dependents
Price on what your own panel shows if you can.
In a made-up example, you charge $70 per employee, $60 per spouse and $30 per child, with a family cap of $190. An employee with a spouse and three children would be $220 without the cap, so the cap applies and they pay $190.
If the employer cares about HSA eligibility, check family pricing against the $300 monthly limit for an arrangement covering more than one person. Here's what the 2026 rules say.
Billing and the census
Dependents need their own lines on the census, linked to the employee. Decide what happens to their dependents when an employee leaves the company. Write down what happens to them. This post covers departures.
In your books
Track employer-paid and employee-paid amounts on separate lines if both exist. Count dependents in your member numbers, split by employer, so revenue per member stays accurate.
What I'd do this week
- Decide whether your standard employer offer includes dependents.
- Set prices for spouses and children, and a family cap if you want one.
- Add a dependents section to your census template.
Common questions
What age should children be covered to?
Pick an age, write it down and apply it the same way every time.
Should a family cap be standard?
It's easy to explain. Test it against your largest families to make sure it still covers your costs.
Can a dependent stay if the employee leaves?
You can offer them an individual membership. Write that option into your departure process.
Want revenue per member that counts families correctly?
We reconcile every account every month and send your P&L and Balance Sheet by the 15th, so decisions like this start from real numbers. If that's what you need, apply to work with us.