California Department of Insurance Final Regulation on Gender Nondiscrimination in Health Insurance

This is the final regulation issued by the California Department of Insurance in 2011, implementing Assembly Bill 1586, which prohibits health insurers from discrimination based on gender, gender identity, or gender expression.

The regulation affirms that California law prohibits health insurers from:

  • Denying, cancelling, limiting or refusing to issue or renew an insurance policy on the basis of an insured’s or prospective insured’s actual or perceived gender identity, or for the reason that the insured or prospective insured is a transgender person.
  • Demanding or requiring a payment or premium that is based in whole or in part on an insured’s or prospective insured’s actual or perceived gender identity, or for the reason that the insured or prospective insured is a transgender person.
  • Designating an insured’s or prospective insured’s actual or perceived gender identity, or the fact that the insured or prospective insured is a transgender person, as a preexisting condition for which coverage will be denied or limited.
  • Denying or limiting coverage, or denying a claim, for services including but not limited to the following, due to an insured’s actual or perceived gender identity or for the reason that the insured is a transgender person: 1) health care services related to gender transition if coverage is available for comparable health care services under the policy when such comparable health care services are not related to gender transition, including but not limited to hormone therapy, hysterectomy, mastectomy, breast reconstruction, surgical treatment for gynomastia, reconstructive surgery for genital injuries or abnormalities, and vocal training; or 2) any health care services that are ordinarily or exclusively available to individuals of one sex when the denial or limitation is due only to the fact that the insured is enrolled as belonging to the other sex or has undergone, or is in the process of undergoing, gender transition.

The final regulatory statement of reasons, providing detailed rationale for the regulation and describing the public comment and amendment process, is here:

Link to Original Source

This entry was posted in Lesbian, Gay, Bisexual and Transgender Health. Bookmark the permalink.

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