Governor Wolf Applauds PA Insurance Commissioner for Issuing Non-Discrimination Guidance to Insurers, Prohibiting Discrimination on Basis of Sex, Sexual Orientation, and Gender Identity

April 27, 2016

Harrisburg, PA – Governor Tom Wolf today applauded Insurance Commissioner Teresa Miller for announcing new Insurance Department expectations for non-discrimination provisions in health insurance policies, including language prohibiting discrimination on the basis of sex, sexual orientation, and gender identity. This guidance, submitted for publication in the April 30 edition of the Pennsylvania Bulletin, will apply to all health insurance plans regulated by the Pennsylvania Insurance Department, which includes individual and group policies purchased through the federal marketplace.

“I am proud of this move by Commissioner Miller,” said Governor Wolf. “We need to ensure that Pennsylvania is a welcoming place, regardless of the color of your skin, your gender, the religion you profess, or the person you love. Next, I am excited to work with Democrats and Republicans in the legislature to pass a statewide non-discrimination bill that protects all Pennsylvanians and makes it clear to the world that Pennsylvania is a welcoming place for everyone.”

“Governor Wolf recently announced that the commonwealth’s policy is to treat all Pennsylvanians with the respect and dignity they deserve, regardless of race, color, religion, sexual orientation, gender, or gender identity and expression,“ Commissioner Miller said. “My department is also committed to doing all it can protect the consumers we serve, and we expect health insurance companies to join in this effort.”

This guidance does not require insurers to cover any particular services that they are not otherwise required to cover. However, under this guidance, health insurance policies under the jurisdiction of the Pennsylvania Insurance Department will not exclude services based on gender identity and will provide coverage for medically necessary covered services regardless of a policyholder’s gender identity.

In addition, health insurance policies will not contain a blanket exclusion of coverage for health services related to an individual’s gender transition.

Commissioner Miller said that her department expects health insurers to include language within policies that specifically details these protections in order to maintain compliance with state and federal laws.

“Denying coverage for medically necessary covered services on the basis of gender violates federal regulations and Governor Wolf’s policy for Pennsylvania, and my department will not tolerate discrimination in the policies that it regulates,” said Commissioner Miller.

The policy is consistent with Section 1557 of the Affordable Care Act, as explained in a proposed rule issued on September 8, 2015 by the Department of Health and Human Services’ Office of Civil Rights. That proposed rule delineated non-discrimination protections on the basis of sex to include sex stereotyping, gender identity, and sexual orientation.

Health insurance providers around Pennsylvania vocalized support for non-discrimination provisions.

“We have a strong commitment to diversity and inclusion and have been recognized regionally and nationally for our responsible actions. Across the state, we serve a very diverse population and believe our employees, policies and actions need to reflect the very communities that we serve,” said Highmark Health Plan President Deborah Rice-Johnson. “We currently provide coverage for health services related to gender transition to our workforce and to likeminded large employer insured groups across the state who choose these benefits and who are committed to supporting the diverse needs of their employees.”

“UPMC Health Plan has been a proud and vocal advocate of diversity and of the fair and equal treatment of all persons, including through our support of the Pennsylvania Fairness Act. We are currently reviewing the Non-Discrimination Notice and will work with the Department to fully understand its scope, objective and practical impact,” said a representative from UPMC Health Plan. “We are committed to ensuring that all of our members, regardless of their sex, gender identity, or recorded gender are treated fairly and have access to the high-quality health care services they have come to expect from UPMC.”

The notice will be available in the April 30 issue of the PA Bulletin and can be viewed online at www.pabulletin.com. Insurance companies that have questions regarding this notice should contact the Insurance Department’s Bureau of Life, Accident, & Health, Office of Insurance Product Regulation at ra-rateform@pa.gov.

Consumers who have questions regarding whether their health insurance policy is affected by these guidelines are encouraged to contact the department’s Bureau of Consumer Services at 1-877-881-6388 or online at www.insurance.pa.gov.

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