State insurance board reinstates gender reassignment exclusion

February 3, 2017

The board overseeing Wisconsin state employee health insurance has dropped coverage of gender reassignment services.

Last July, the state Group Insurance Board (GIB), the panel that sets policy and oversees administration of the group health and life insurance for state employees and retirees, had approved the removal of an exclusion for gender reassignment services based on an interpretation of a newly finalized federal requirement under the Affordable Care Act. The change was effective January 1, 2017.

However, since the State of Wisconsin is part of a federal lawsuit challenging this federal requirement, the GIB reinstated the exclusion following urging from the Wisconsin Department of Justice to do so.

As a result, effective February 1, 2017, surgical services, procedures, hormones and supplies related to gender reassignment are no longer covered for participants of the State of Wisconsin Group Health Insurance Program. Therefore, state group health insurance only covered gender reassignment benefits from January 1 through January 31, 2017.

For more information, please go to 2017 Uniform Benefits and Services Related to Gender Reassignment or Sexual Transformation – HHS Nondiscrimination Rule.

UW-Madison employees with questions or concerns are urged to contact the Office of Human Resources at 265-2257.