Corporate Equality Index: Criteria 3.0 - Health Insurance for Transgender Employees and Dependents
Benefits-eligible employees and dependents firm-wide must have access to at least one health insurance plan that:
- Covers transgender-specific treatment (mitigating "transgender" or similar exclusions for care) and
- Conforms to the WPATH Standards of Care[1] in determining treatment coverage eligibility (mitigating "medically necessary" and "cosmetic" exclusions), including the clarification statement from 2008.
Coverage must be demonstrated through sufficient documentation, including one or more of the following:
- Preferred: Excerpt of summary plan description (SPD) –or–
complete summary of material modifications (SMM) indicating coverage - Excerpt of insurance contract’s language referencing clinical guidelines for coverage –and–
the clinical guidelines - Insurance contract amendment indicating coverage
- Insurance contract’s full list of exclusions that show no transgender exclusions
- Press release or other benefits notice to employees indicating coverage
Helpful Resources
- List of employers that have implemented benefit
- Best practices from employers that have implemented benefit
- About WPATH and Download the Standards of Care
- Coming Fall 2009: Comprehensive resource including
- Model policy language
- Treatment requirements based on WPATH Standards of Care
- Policy examples
- Analysis of projected cost
- Parameters of HRC policy review
Frequently Asked Questions
- Is it expensive?
- What about reparative therapy?
- How are transgender-inclusive benefits included in the CEI?
[1] Also the “Harry Benjamin International Gender Dysphoria Association’s Standards of Care for Gender Identity Disorders.” HBIGDA changed names to the World Professional Association for Transgender Health. Available at: http://wpath.org/Documents2/socv6.pdf