Susan's Place Transgender Resources

so. in reference to http://transgenderlawcenter.org/archives/4273
where it says
"What does this mean for individuals who live in California and work for a company based out of the state?

All employees residing in California are impacted by the ruling, unless covered by a self insured plan. Many large companies are self insured. The DMHC Helpline can help you determine what kind of health plan you have.  Kaiser Permanente, one of the largest insurers in California, is regulated in California and subject to DMHC guidance."

i am currently employed at wal-mart which has its insurance through blue cross/blue shield administrators of arkansas which includes a blanket exclusion that denies any and all healthcare related to transitioning for transgender individuals.  because i have been working there longer than a year, the insurance is "available"  which means i dont qualify for medi-cal or any of the plans through covered california, so my choices are the insurance through work or pay 300$+/mo for my own personal insurance.

in states that dont allow the blanket exclusion, shouldnt employers be required to provide insurance that comes from that state?

at the point where i will eventually be getting surgeries i will no longer be working at wal-mart so i wont be worried about this at that time, and will be going through a hormone clinic so its affordable but i figure this might be helpful for anyone else in california working at wal-mart, or another company that is out of state.   im waiting for a reply back from a legal perspective regarding this and will post their reply when i get it.

Sorry to say you and I are in the same boat.  I have BCBS through the Federal Employee Benefits (FEB) system.  I could have changed to Atnea and would have been covered, but missed the open enrollment period.  BC/BS didn't change their exclusion for the FEB program only for those who use BC/BS of CA get covered, because CA made them cover it. 

I wonder if there are enough of us in the BC/BS FEB program we could file a class action lawsuit for gender discrimination. 

dont know. since the state my insurance is through doesnt have gender included in its anti discrimination laws.  surgery is still a ways off and im likely to be switching plans by then thankfully.

@Alana_Jane: Remember that (for better and for worse) the federal government is not bound to state laws/regulations.

gotta remember that bc/bs isnt just 1 company.  each of the individual state versions is completely different, some may or may not have the exclusions for trans* based care depending on which state the company is from.  bc/bs of arkansas is a different company from bc/bs of california, they just have the same basic guidelines on how the company is run.  unfortunately id have to lose my job, in order to switch insurance cause medi-cal and covered california because i have insurance "available" to me through my place of employment.  so. its either, pay for my care myself, pay 300-400$/mo for insurance that other than having trans related care included is identical to what im currently paying 22$/mo for, or lose my job and try to find another one that doesnt immediately have insurance available.

Quote from: tgchar21 on December 29, 2014, 09:26:35 AM
@Alana_Jane: Remember that (for better and for worse) the federal government is not bound to state laws/regulations.

I'm fully appreciative of that.  But given the anti-discrimination policy of the AG office, plus the fact that Atnea does cover TG services for federal employees.  Could the argument be made that by all the other plans excluding treatment, they are de-facto discriminating against us.  I don't know, and since I'm not a lawyer...  But it seems that this simple argument should hold water, but again I'm not a lawyer. 

What should really happen is each plan should be forced to follow the Atnea template, and include TG coverage.  It's obvious that Atnea isn't going under due to serving our community. 

What I should have done is switch during the last open enrollment, but I had hope that BC/BS would have changed, and should have changed, such as is required under the BC/BS of California.  We've been with BC/BS for over a decade, fifteen years if you include my time in the UC system.  My current therapist is covered but not by Atnea, none who deal with TG issues in my area are.  If there's anything anyone is doing to make all of the FEB programs cover us, I'm all for being included.

-Alana