Company Health Plans

  • Creator
    Topic
  • #32986
    Kirsten C
    Participant

    So I was just wondering if anyone has lobbied their companies for proper trans care on their plans?

    My current company has great health coverage, and it does cover a portion of the transition surgeries, but not all of them. I am of the opinion that anything that can be deemed “medically necessary” should be covered. That would cover things like top and bottom surgery, some pieces of ffs, electrolysis, voice and tracheal surgeries, voice lessons, and possibly even body hair laser treatments. And I have talked to the health care providers that we use about coverages and most of this is covered under their basic ppo plans. But since my company is self insured, we have our own policy which mirrors a lot of theirs, but not all. Case in point is top surgery. For mtf and ftm it is covered under the public ppo, but only ftm is covered under ours. Why? Because breast augmentation for a cis female is not medically necessary unless there are extenuating circumstances such as cancer. At least for my plan. But for me it is a necessity to present as myself and limit my anxiety and dysphoria.  Especially since I work with the public every day.

    So my plan is to collect data from other trans individuals that have fought this battle already, gain the backing of both my union t6 council, and local political organizations that lobby for lbgtq+ imdividuals, and present to the company when I finally acquire my meeting with our ceo or board of directors. But I’ve never undertaken such a massive endeavor and if anyone has had any success or even just experience I would love to hear about it. I have found a good number of articles about people that have fought for this and won. Most required court or at least arbitration, but having those letters that deem these things “medically necessary” compounded on the fact that gender dysphoria is now widely accepted as a medical condition is really a killer when it comes to these stages.

    Ok I am rambling now. Thanks for anyone who has any info at all that could help me in my undertaking. It is truly appreciated.

    Kirsten

    3 users thanked author for this post.
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    • #90920
      Jamie Harris
      Participant

      FREE

      Well be glad that you are not in the south. I work for a national company headquartered in the south and  all trans related surgeries are excluded.  With the exception of prescription medication.

      If you have it take advantage of it.

    • #90919
      Evelyn Jaye
      Participant

      FREE

      As DeeAnn noted, the CEI can be used if your company does recruiting, or has a public image it is trying to improve. That is what our LGBTQ+ Employee Resource Network has done a couple of times (it’s hard to ask for the world the first time…). We are self-insured, so it is all internal to the company to make these points. So far we have top and bottom, breast aug, FFS, laser and electrolysis- both facial and GCS, Trach and vocal, and of course therapy and HRT. The only thing I can think of that we don’t have, yet, is hair restoration.

       

      The last number of years, the company has also been doing a lot with Diversity and Inclusion, to the point of signing on to the UN “LGBTI Standards of Conduct for Business” and the “Women’s Empowerment Principles”. And earlier this year, they made a $50 million donation supporting racial equality. With all that, it seems to be getting easier to have inadequacies corrected.

    • #89679
      Vanessa Torres
      Participant

      FREE

      This is very interesting and I will be following. I work with the public as well. My job isn’t private sector though, I work for transit. It’s a state agency. I wonder how my plan compares to yours.

    • #89633
      DeeAnn Hopings
      Ambassador

      AMBASSADOR

      As a follow-up…

      In January 2016 I retired from Corning, Inc. For 12 years I was a part of our LGBT employee affinity group. The Human Rights Campaign does a yearly survey called the Corporate Equality Index (CEI). From the responses, compared to the criteria, a ratings number is developed. This isn’t a matter of throwing nice words on a page. It is a pretty comprehensive survey that asks very particular questions about corporate policies regarding LGBT folks and you have to be able to document what you say you are doing.

      What we eventually figured out was that the CEI could be used as a recruiting tool. Corning has alway been very protective of its public image. Doing well on a nationally recognized quality LGBT survey sends a strong message to potential employees, as well as potential customers. The number of people who check the degree of social conscience exhibited by a potential employer is steadily increasing.

      Several years ago one of the areas of the survey dealt with medical benefits related to trans people. It took a while, and a lot of convincing in terms of the recruiting message, but policies were put into play to address this. The survey set $50,000 as a minimum. A few years later the amount was raised to $75,000 in the survey. That was a no-brainer and didn’t require any lobbying on our part as corporate officials had already realized the value of the CEI.

      I don’t know about your company, but recruiting very good scientists and engineers is crucial to Corning’s business model. The concentration is on inventing materials and processes that no one else has. That is what justifies high profit margins. We are not very good at commodity businesses.

      You can find current and historical information at the HRC web site HRC.org

      1 user thanked author for this post.
    • #34382
      Kirsten C
      Participant

      FREE

      Well after about 3 months of working with non profits, law firms, and on my own, my healthcare battle has ended!

      So first of all, I have changed my companies policy very minimally. They have agreed to accept all trans care surgeries that are deemed “medically necessary” by the provider. Which is a small step forward. But one of the non-profits I’ve been working with has a national case vs United to extend what they consider “medically necessary”. So if they win, it’ll all be covered! I may still play a small role in that battle, but not like my current involvement.

      As for my personal battle, after talking to my therapist and her talking to the surgeon I want to use for gcs, I was tipped off to a better possibility than I was going after. It seems my company has an additional plan with blue cross which covers ALL the procedures I was trying to get covered!!!  So this fall I simply have to enroll in a new plan!! FFS, top surgery, bottom surgery, and even electrolysis for bottom surgery have all been deemed medically necessary! All that is required is a letter form the surgeon that’s says it is necessary. And that’s no issue at all!!! So come this October I can finally start booking procedures!!!

      To say I’m happy would be the understatement of the YEAR! Lol. I am literally floating!!! YAAAAYYYYYY!!!

      1 user thanked author for this post.
      • #34402
        CC Webb
        Managing Ambassador

        MANAGING AMBASSADOR

        That is fantastic news Kirsten!  I can only imagine the euphoria you are feeling.  Your “small part ” is meaningful and we thank you for sharing.  It’s even more encouraging to see that it may play a part in a major carriers overall offerings.

    • #33361
      Kirsten C
      Participant

      FREE

      Update…..

      as of now I have had conference calls with executive board members at my company and with my health care provider. I have no definite yes or no’s at this point, but from the information I have given them, and I think some of my own experience, top surgery will be added into our corporate trans coverage! There is a line in the current Obama aca that states that no surgeries can be excluded from trans care if they are covered under other diagnoses. So case in point for top surgery is cancer. If a cis woman has to have he breasts removed, insurance will cover implants if they are so desired. They are considered medically necessary. So the same must be upheld for a trans patient. This simple idea seems to be enough to change that policy. Another is electrolysis for gcs. If it is  mandated by the surgeon, they must pay to reimburse at least some of the cost. It can be considered part of the procedure even though it’s not directly involved.

      I am pushing for brow bone, chin and jaw line, tracheal shave, and facial electrolysis as well but those are all much more difficult to convince people of. My angle here is simply anxiety. But I’m not too sure how far that will get me.

      Thats all for now. I’ll try to keep updating my progress. But at this point I am very happy with everything so far.

      1 user thanked author for this post.
    • #33123
      CC Webb
      Managing Ambassador

      MANAGING AMBASSADOR

      Following

       

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