Oregon Addresses Gender Identity Issues and Health Insurance

The Oregon Insurance Division has been receiving questions about how insurers should handle coverage for conditions related to gender identity under the state’s new Oregon Equity Act, so it has developed six principles to provide some guidance.

A bulletin sets out principles the division applies whenaddressing questions related to GI/GD and insurance. The commissioner will continue to apply these principles to questions related to gender identity/gender dysphoria (GI/GD) and the transaction of insurance.

They are:

Principle #1: An insurer may not discriminate on the basis of an insured's or prospective insured's actual or perceived gender identity, or on the basis that the insured or prospective insured is a transgender person.

Principle #2: A health insurer may not deny or limit coverage or deny a claim for a procedure provided for GI/GD if the same procedure is allowed in the treatment of another non-GI/GD-related condition.

Principle #3: Although a health insurer may categorically exclude coverage for a particular condition or treatment, the insurer may not base such exclusion on gender identity.

Principle #4:The mandated coverage for mental health services must include mental health counseling and treatment related to GI/GD.

Principle #5: The perceived gender identity of a person should not prevent appropriate treatment.

Principle #6: The Insurance Division expects insurers’ forms to comply with the policy expressed in SB 2 as it is incorporated into insurance regulation with this bulletin.

The complete bulletin may be found online at http://www.cbs.state.or.us/external/ins/bulletins/bulletin2012-01.pdf.


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