Commissioner: Private insurance carriers must provide equal coverage for transgender people

CARSON CITY — Private insurance carriers in Nevada cannot exclude or deny transgender people coverage for medically necessary treatments if such procedures are covered for other people, the state’s insurance commissioner said in a bulletin released Monday by a transgender advocacy group.

In the bulletin dated June 25, Insurance Commissioner Scott Kipper said both state law and administrative code “prohibit the denial, exclusion or limitation of benefits relating to coverage of medically necessary health care services on the basis of sex as it relates to gender identity or expression.”

Accordingly, the Division of Insurance, he said, will not approve policies with “exclusionary language” that deny such benefits or coverage.

The bulletin comes after the Nevada Public Employees’ Benefit Program voted in November to begin covering transgender health services on July 1 for state workers or their covered dependents insured through the state-funded program or affiliated Health Maintenance Organizations.

Previous language in the state insurance design plan excluded treatment designed to alter physical characteristics and any other treatment related to sex transformations. PEBP officials said an actuarial report concluded that providing coverage for transgender health procedures would have little to no impact on the program’s overall financial health or claims liabilities.

The city of Reno also recently began offering services for transgender procedures.

Mark Krueger, counsel for the Nevada Division of Insurance, said the bulletin “provides guidance for insurance carriers that they cannot any longer exclude any kind of medically necessary coverage based on gender identity or expression.”

Brock Maylath, president of the Transgender Allies Group, welcomed the directive.

“Most insurance have had language that denies coverage for certain medically necessary treatments for transgender people, based only on who they are, while covering identical procedures for others,” Maylath said. “This has been in violation of federal law, as well as the Nevada laws as indicated in this bulletin.”

Maylath explained that others might undergo such procedures after a traumatic injury or illness, for example.

“If you cover it for one person you have to cover it for everybody,” he said.

The bulletin does not pertain to companies that have self-funded health plans, though Maylath said many big corporations provide transgender coverage.

Maylath said he is working with other state officials to expand transgender health benefits to Nevadans covered by Medicaid.

Contact Sandra Chereb at schereb@reviewjournal.com or 775-687-3901. Find her on Twitter: @SandraChereb