Caps and Transition-Related Title Coverage: Unnecessary and Uncommon Dollar caps on areas of coverage are often utilized to control for perceived risk. However, such caps also represent insurmountable barriers to care in many cases, and when they limit care for an entire class of people, they are discriminatory. HRC research on utilization has shown that claims costs are extremely low, and therefore risk is low. Only 16 of the 85 businesses (19 percent) reported a financial cap, ranging from $10,000 to $150,000, and half of these reported caps of $75,000 or greater. All of these 16 businesses reporting dollar maximums self-insure this coverage.
l Many of the first businesses to implement inclusive coverage place no separate dollar limits on this area of coverage. Of the 85 businesses that reported many transition-related treatments would be covered, 69 businesses (81 percent) had no dollar caps on this coverage.
Although risk of adverse selection is much greater for smaller employers, and those employers are more likely to be fully insured and have less flexibility in plan design, HRC found that numerous smaller fully insured employers have negotiated inclusive benefits with no caps. Of those with caps, the smaller employers tend to have more generous caps while the largest employers tend to have most restrictive caps.
l In-depth interviews with a subset of employers indicated that there had been little or no initial increase in premiums, that both absolute and annual per employee costs attributed to benefit utilization had been minimal, and that there had been no impact on subsequent premiums.
Companies that Offer TransgenderInclusive Benefits
18 27 33 72 78
% % % % %
85 Offer health benefits for surgical procedures 133 Offer medical visits and lab procedures related to hormone therapy 161 Offer pharmacy benefits for hormone therapy 350 Offer mental health benefits for counseling by a mental health professional 378 Offer short-term leave for surgical procedures
Corporate Equality Index 2O11: Rating American Workplaces on LGBT Equality
www.hrc.org/cei
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