MONTGOMERY, Ala. (AP) - Alabama’s largest insurer now offers spousal coverage to legally married gay couples in order to comply with a federal rule that insurance companies must treat married couples the same regardless of sexual orientation.

A spokeswoman for Blue Cross Blue Shield of Alabama said the company began offering same-sex spousal coverage for underwritten plans in early 2014, “in response to the Centers for Medicare and Medicaid Services’ regulations that prohibit health insurers from discriminating in health plan coverage on the basis of sexual orientation.”

The state of Alabama does not currently recognize same-sex marriages and has a ban on gay marriage written into the Alabama Constitution. However, the Department of Health and Human Services issued guidelines in March reiterating that same-sex couples, who were legally married in any of the states that currently authorize gay marriage, are entitled to the same coverage as heterosexual couples.

“Under this CMS rule, if a health insurer offers coverage for opposite-sex spouses, then the insurer must also offer coverage to same-sex spouses that are legally married in any state regardless of the state of residence,” company spokeswoman Koko Mackin wrote in an email.

The Obama administration in March urged insurers to voluntarily comply. It becomes a requirement for coverage beginning Jan. 1, 2015, according to the HHS guidance.

Mark Fowler, a spokesman for the Alabama Department of Insurance, said the department did not know how many companies in Alabama were currently offering spousal coverage to legally married gay couples.

The requirement applies to underwritten insurance plans, and includes both those sold on the federal insurance exchange and many, but not all, of the plans sold to directly to individuals and companies.

Plans grandfathered in under the Affordable Care Act and self-insured plans, where large employers run their own programs, were not affected by the federal rule.

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