Availability of Transgender-Inclusive Group Health Insurance Plans
Most employers purchase a commercial group health insurance plan, where the insurance company spreads risk among its group health insurance plans, which encompass multiple employers. The inclusive plans offered by these businesses are, to the knowledge of the Human Rights Campaign Foundation, self-insured, meaning that the business is sufficiently large and has enough employees for the business itself to assume all the risk of providing health insurance to its employees. Employers that self-insure still generally utilize the expertise of a large insurance company to administer the self-insured plan.
Smaller employers, which generally do not have the option to self-insure their health benefits, need to negotiate aggressively for inclusive benefits with their insurance providers. Insurance providers in certain states have begun making access to transgender-related care available through commercial plans — it is up to an employer to ask for coverage and often to educate an insurer about inclusive plans available elsewhere.
The earliest smaller employers that provided some form of coverage have apparently done so by providing a self-insured benefit outside of the standard commercial health insurance plan, with a lifetime maximum financial benefit. The Human Rights Campaign and the Whitman-Walker Clinic of Washington D.C. both implemented limited self-insured benefits along these lines within the last five years.
