I'm not really sure which sub forum to place this in so I hope this is close enough.

First some background. I've worked in the same job for going on 13 years for a community college in California. The school has always been supportive of diversity and when I transitioned (almost two years ago), they were quite supportive. However our insurance (like most) has specific exclusions for covering anything trans related. I happen to know for a fact that the University of California system covers trans well everything.

Each year our HR department renews the contract with our insurance provider and any changes to the plan need to happen during this time. In light of the recent AMA resolution (122) I'm planning to meet with the head of HR and plea the case that they should (at least try to) get the exclusions changed to inclusions. I must admit that I'm not the most qualified person to make this plea, however I'm quite certain I'm the only one who has any interest in making the effort. I was hoping that people here on the list might have some ideas for talking points when I have my meeting.  I certainly plan on showing the AMA resolution as well as the University's insurance (btw both are Blue Cross of California, just different versions of it).

Does anyone have any ideas for good points to bring up?


Thanks, Holly

No suggestions, just well wishes.  I am looking at the policy right now.  I have looked at it every year for the last 5 or 6 years hoping it would change. 

Sarah L.

Ok so I've composed a draft email I plan on sending to the head of HR. She will begin talks with our insurance provider later this week. I'd love to hear everyone's oppinion on the letter, perhaps making suggestions? I'm currently planning on showing the letter to my therapist tomarrow and will compose my final draft after that meeting. It will give the head of HR very little time to read and digest since her first meeting is on Thursday, but it took me quite a while to research and write the letter.

So let me know what you think:


Dear Dxxx,

I am respectfully writing to you with a request regarding our Health Insurance coverage.  I would like you to investigate and perhaps pursue what it would take to add benefits for treatment of a condition that is currently not covered.  In this letter I will outline my justifications as well as provide additional resources for further information on the topic.

Gender Identity Disorder is a well documented condition that is easily treated with methods that are proven effective, the rate of occurrence is extremely low, and the cost is minimal when compared to other common surgeries such as the delivery of a baby. XXXXX Community College District should endeavor to have its health insurance provider include treatment for Gender Identity Disorder given that this would more accurately reflect its Mission: "committed to serve the needs of our diverse community", It is already being covered at many other California educational institutions and it's just the right thing to do.

The intention of health insurance is to reduce the financial burden associated with serious medical conditions that the insured may be faced with. It seems unjust that an insurance provider be allowed to specify an exclusion for a medically recognized condition that is easily treated but due to its nature carries with it a moral stigmatization.

There is already strong precedence for inclusive coverage rather than exclusive writs in the state of California. The city of San Francisco decided in 2001 to begin to cover transgender related health care. Based on the 28,000 employees they had at the time they anticipated as many as 35 people might use the benefit each year. They initially calculated a rise in premium of $1.70 per employee. Five years later (2006) after real empirical statistics had been gathered they dropped the per employee charge entirely due to significantly fewer claims than originally anticipated. The city of San Francisco may have been the first but since 2001 many institutions in California are insisting that this aspect of heath care not be overlooked or purposely eliminated from their insurance providers. Several of the UCs to include transgender benefits include: UC Santa Barbara (2005), UC San Diego (2007), UC San Francisco (2008), UC Santa Cruz (2008), and UC Riverside (2008). In fact this trend is not limited to California. Nationally, institutions for higher education that include transgender health coverage include to some degree or another are: Emerson College, University of Michigan, University of Vermont, Washington University, Bridgewater State College, Harvard University, Ohio State University, Penn State University, Princeton University, and Suffolk University. The insurance companies who are providing insurance are very well known and include Blue Cross, Kaiser Permanente, Health Net, and PacifiCare.

Recently the American Medical Association (AMA) came out with a resolution on the topic titled "Resolution: 122 - Removing Financial Barriers to Care for Transgender Patients". The resolution states: "That the AMA opposes categorical exclusions of coverage for treatment of gender identity disorder" Furthermore they outline all the types of coverage that they believe to be the ethical treatment for this medical condition. They site that Health experts including the World Professional Association for Transgender Health (WPATH) have rejected the myth (sited by many health insurance providers) that such treatments are "cosmetic" or "experimental" and the recognized treatments can provide safe and effective treatments for a serious health condition.

The bottom line is, XXXXX Community College District should make a concerted effort to have its health insurance provider include treatment for transgender care. It is my understanding that you will be meeting with our insurance providers soon to discuss the coverage costs for the next year, during that time, I would like to request that you  investigate and preferably actively pursue inclusion of treatment for this very serious condition. I would welcome any questions you may have and may be able to serve as a vital resource should you need any additional information.

I look forward to hearing back regarding how my concerns were addressed.

Sincerely,
Holly

Additional Information:
www hrc.org/issues/7782.htm
www ama-assn.org/ama1/pub/upload/mm/16/a08_hod_resolutions.pdf
www uclgbtia.org/transhealthupdate.html
www uclgbtia.org/transhealth.html

Short, to the point, and with good references. I think it looks pretty good.

Good luck and please let us know how it works out.

You might wish to try a little reverse psychology here, perhaps show that the US is lagging far behind Europe when it come to trans issues, such as legal recognition, passports/drivers lisense/birth certificates/social security/pensions/inheritance etc.,   can it be possible that the greatest republic on the planet can be satisfied with being behind the war ridden Europeans with the miriad of Monarchies and republics and federations and territories under Nato/UN control? 

Holly? You have a wealth of material to call upon but I think that suggestions of US 'ignorance' of translife in the wider world might liven debate 

Hi Holly, what a great idea!

I'd leave out psychologizing of any sort and simply go with the main points you've laid out so well, Holly. An admin isn't gonna want to read a tract about trans. However, she may well be very open to the arguments you've set down. I'm with Syne on this. I'd say you've made a short and excellent proposal that may well be looked on favorably.

That's a really good piece of work. I hope she follows on after it with the goods.

Nichole

Well I've done all I could do. I sent her (and the ladies in the benefits office) the email today. I was hoping for some kind of email back acknowledging receipt but got none so I called one of the ladies in the benefits office and asked if they had got the email. She said that they had and that they too thought that the argument was a good one. In fact she said something to the effect of "laid out like this we look totally silly for not having coverage" she is not the decision maker but her remarks made me feel pretty good. She did add to the end of that phrase that she hopes her boss (the head of HR) sees it the same way. One thing that she added (and I didn't like very much) was that they will probably forward the email on to the provider and see what they say. Which sounds an awful lot like well thanks for the great letter but now we can't be bothered request information on our own we'll just see how the insurance company responds to it.

If I had known the real audience wasn't going to be HR, I'd have written the letter differently.  Oh well maybe it'll work out and maybe it won't but at least I tried. Tomorrow is the first meeting of the year that HR meets with the insurance providers directly to negotiate the rates for next year. So everyone needs to keep their fingers crossed for me.

tfn

corrected birth defects help increase workplace productivity?

ANewMe,

Follow up your email with a hard copy. They have to file that.  They have to keep it on record.  Email get's lost, not everyone reads it, and although it is an "official document", one on paper is more official yet.

Just walk a copy over to your HR reps and tell them.  "This is a hard copy of an email I sent to Roberta.  I wanted to make sure that it officially goes on record."

I like your letter.  It is succinct and cites references.  And about being the most qualified? You are THE most qualified.  I'm proud of you!

Cindi

Spurred on by the recent AMA resolution I too talked to Human Resource this week.  They can't do anything, we're the last link on a long corporate chain, but they were receptive and sent it up to corporate for consideration.  I showed my HR chief the insurance exclusion in our plans handbook (No sex change surgery or any treatment of gender identity disorders.) and I gave her:

A copy of the SOC (highlighting pg 18, section X):

QuoteSex Reassignment is Effective and Medically Indicated in Severe GID. In persons diagnosed with transsexualism or profound GID, sex reassignment surgery, along with hormone therapy and real-life experience, is a treatment that has proven to be effective. Such a therapeutic regimen, when prescribed or recommended by qualified practitioners, is medically indicated and medically necessary. Sex reassignment is not "experimental," "investigational," "elective," "cosmetic," or optional in any meaningful sense. It constitutes very effective and appropriate treatment for transsexualism or profound GID.

A copy of the AMA's resolution about non-discrimination (4-2007)

A copy of the AMA's resolution calling for the end of insurance exclusions. (6-2008)

A copy of GLAD's letter praising the AMA (6-2008)

A copy of WPATH's letter seconding the AMA and calling transition medically appropriate and necessary. (7-2008)

A copy of the article "Making Insurance Work For Transsexuals" by Erika Ervin.  An insurance industry insider she draws on the San Francisco experience of providing insurance coverage and various studies to conclude: That if all exclusions were eliminated nationwide the average cost increase per insured person per month would be 2¢!  You read that right, the insurance companies decided years ago that we aren't worth 2¢.

http://www.inlamag.com/1015/special_reports/sprt2.html


I thanked her for her time and hope this helps someone who comes after me (I'm already done).