State reinstates transgender benefits exclusion

The state has reinstated an exclusion on benefits related to gender identity effective Wednesday, according to a memo from the Department of Employee Trust Funds.

At its December meeting, the Group Insurance Board decided that it would backtrack from its decision earlier in 2016 to cover gender reassignment surgery and other related treatments if four contingencies were met.

In a memo to GIB members released Tuesday, ETF Secretary Robert Conlin said that the final contingency was met after ETF issued a contract amendment to all participating health plans that will reinstate the exclusion.

A federal judge in Texas issued an injunction barring enforcement of provisions of the federal health reform law that extended anti-discrimination protections to transgender health services at the end of December, fulfilling one contingency. Wisconsin is one of the states involved in that suit.

On Jan. 13, the Wisconsin Department of Justice provided an opinion confirming the action doesn’t constitute a breach of the board’s fiduciary duties. Segal Consulting provided a report on Jan. 23 showing that reinstating the exclusion would not increase program costs. Those fulfilled the other two contingencies.

Segal estimated that two to five people covered through the plan may pursue the surgery and that the annual cost would have ranged between $100,000 and $250,000.