Transgender Benefits


As the executive sponsor for my company’s LGBT Employee Resource Group as well as an out gay executive in the company, I started to talk, last month, with the head of human resources, who is responsible for the health insurance that our employees receive, about adding transgender health insurance coverage. This year transgender benefits were excluded from health insurance coverage for our employees.

My company does what many large employers do, we are self-insured. That means we hire an insurance company to administer our benefits, but we are the actual insurance company, so we get to pick and choose what actually gets covered by the insurance.

I began to get interested in and learn about the lives of transgender men and women a few years ago, and have since read a number of books on the topic, mostly autobiographies. The issue of transgender inclusion and equality is important to me. Today my company has two transgender employees that we are aware of. The fear, by the company, was that if we added transgender benefits for our employees, we would become a magnet for other transgender employees with expensive healthcare needs. This always seemed like a silly argument to me since any individual applying for a job still had to meet the qualifications for the job. I also recognize the level of discrimination that goes on in the hiring process towards transgender individuals.

In September of this year, the transgender health insurance landscape had a sea change. Health and Human Services (HHS), the part of the federal government that oversees the Obamacare insurance program, announced a proposed rule, (in the non-discrimination provision of the Affordable Care Act, Section 1557), that would ban transgender discrimination in health insurance benefits. The rule has a comment period that ends this month and would go into effect sometime in 2016. 


Suddenly my company was not blazing new trails but was a laggard in a cultural sea change that is taking place very quickly. If the HHS rule goes into effect, which it most likely will, it would ban discrimination of health insurance for transgender individuals. The rule has a sweeping impact beyond the Obamacare exchanges. It covers CHIP (the federally mandated Children’s Health Insurance Program), Medicaid, Medicare, Individual and Small Group, (company’s with 2-50 employees), insurance at a minimum. But as I understand the rule, it also covers an insurance company that takes any federal money, which is almost every insurance company in the country and requires them to remove transgender exclusions from ALL their commercial policies.

I learned this week that my company will be removing the exclusion of transgender coverage in our 2016 benefits. A small victory on the road to equality and inclusion. Now comes the hard part: developing the programs to help managers and teams understand how to work with a transgender employee or to support an employee transitioning on the job. Our LGBT Employee Resource Group will be working this year with human resources to understand the challenges of transgender employees and help develop training materials for managers and teams so that we can support transgender employees in an appropriate and respectful manner.

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