Same-sex couple has insured partnership through Carilion [The Roanoke Times, Va.]

Jan. 27--They met at a party 19 years ago. Then came the first date, and later the decision to share a home and spend their lives together.

"In every sense of the word, we feel married," Kim Roe said of her relationship with Jeannie Mann.

There is no marriage license, no civil union document. But at last, Roe and Mann have something in writing that recognizes their long-term relationship: a domestic partner health insurance plan.

The coverage is provided by Carilion Clinic, where Roe works as senior director of emergency medicine. Effective Jan. 1, Carilion began offering insurance benefits to the domestic partners of its gay employees.

That means Roe, a 27-year employee of the Roanoke-based health care system, and Mann, a receptionist at a local car dealership, can consolidate their insurance costs and health care under a single plan.

"It's very generous and a great opportunity for us," Mann said.

The move by Carilion, the region's largest private employer, is consistent with a national trend that began more than a decade ago but was slower to catch on in Southwest Virginia.

"Although I haven't personally seen a large number of employers in the Roanoke Valley electing domestic coverage, it seems to be a question arising more and more often, particularly with larger employers," said Tracy Hale, board president of the Roanoke Valley Society for Human Resource Management. "I believe it's something employers will be considering in the future, if they haven't already."

More than half -- 62 percent -- of Fortune 500 companies offer domestic partner benefits to their employees, according to a report by the Human Rights Campaign, a civil rights organization that works on behalf of gays and lesbians.

On a broader scale, a second survey of businesses large and small by the Kaiser Family Foundation found that 31 percent provided the benefits last year to same-sex domestic partners.

Advocates of the practice describe it as a way to recognize diversity and attract more qualified job applicants by offering to gay employees in committed relationships a basic benefit that has long been available to heterosexual married couples.

'The right thing to do'

Carilion officials said the decision to expand health care coverage to same-sex domestic partners came as part of a continuing review of its benefits package.

"It's really about what is the right thing to do for your workforce," said Heather Shepardson, Carilion's senior director of human resources.

The plan covers couples in three types of same-sex unions: marriage in a jurisdiction that recognizes gay marriage, a civil union in a permitting jurisdiction or a domestic partnership that meets eight criteria.

To qualify for the third category, couples must sign a sworn statement attesting that each is the sole domestic partner of the other.

That includes sharing a home and being responsible for each other's welfare. The affidavit also states that neither person has had another domestic partner within the past 12 months.

The children of the employee's domestic partner also are covered by the plan.

While Carilion does not offer domestic partner benefits to opposite-sex couples, it says that is being considered.

"We will often 'phase in' benefit changes, which allows us evaluate our approach and make adjustments based on employee needs and feedback," spokesman Eric Earnhart said.

Carilion introduced the coverage to employees with same-sex domestic partners last fall as part of open enrollment for health benefits that took effect at the start of the year.

IRS complications

So far, 11 Carilion employees have elected to take the domestic partner coverage.

Although it is unclear how many employees were eligible, one reason for the seemingly low number could be how the benefits are taxed.

When an employer contributes to the cost of health insurance for its workers and their legally married spouses, the amount does not count as taxable income.

But under Internal Revenue Service rules, the value of Carilion's portion of coverage for the domestic partner of an employee must be reported for tax purposes.

The only exception to the rule is when the domestic partner of the employee qualifies as a tax dependent -- generally, someone who relies on the employee for more than half of his or her financial support.

A Carilion employee who takes coverage for a domestic partner will have two paycheck deductions, with the employee portion of the premium taken on a before-tax basis and the domestic partner portion taken on an after-tax basis.

To complicate the matter further, the difference between the full cost of coverage for the domestic partner and what the employee pays as a premium is considered "imputed income" and is taxable.

In many cases, the extra tax burden under the IRS requirements can outweigh the advantage employees might have realized by enrolling in the domestic partner plan.

When Carilion offered the coverage, "we didn't know what to expect, because we knew the financial impact would be a determining factor," Shepardson said.

The plan is most attractive to employees with domestic partners who have no health care insurance or limited plans of their own. Otherwise, domestic partners with employer-sponsored plans are likely to keep their own individual coverage so they don't have to pay more in taxes.

A national issue

The tax implications of domestic partner benefits are a problem across the country, gay rights advocates say.

"We certainly know couples who, as much as they would like to take advantage of these benefits, can't afford to because of the extra tax implications," said Janson Wu, a staff attorney with GLAD, or Gay & Lesbian Advocates & Defenders.

"I think it just illustrates that fact that, as much as opponents say you can work around these problems and that gays and lesbians don't need the benefits offered by marriage, that is just flatly wrong."

On average, gay and lesbian couples have a tax liability of about $1,200 a year that their straight counterparts do not, said Deena Fidas of the Human Rights Campaign.

While straight couples who receive domestic partner benefits face the same tax liability, they can avoid it by getting married.

The federal Defense of Marriage Act -- which is currently under court challenge -- prohibits such an option for gays.

"Even if you have a gay couple that gets married and it's a legal marriage, the Defense of Marriage Act is the law of the land when it comes to all federal rights," Fidas said.

'An outdated policy'

Carilion's decision to offer domestic partner benefits comes at a time when the health care system is placing a greater emphasis on diversity.

Officials are in the process of assembling a task force that will help them meet that goal.

"When your mission encompasses every member of the community you serve, staying attuned to the diverse facets of your community is important," Carilion President and CEO Nancy Agee wrote in a Jan. 1 newspaper op-ed column announcing the task force.

In the column, Agee made a public apology to Will Trinkle and Juan Granados, same-sex partners who said they were granted a family membership at Carilion's Roanoke Athletic Club, only to later have it withdrawn because they are gay.

One week after Trinkle and Granados made the allegations in a lawsuit, Carilion changed the club's family membership into a household membership, which covered the two men and their 3-year-old son.

Agee called the original plan "an outdated policy that contained a narrow definition of the concept 'family.'"

Following the incident, "one of the decisions we made was that this is a good time for us to look broader and deeper at what we can do as an organization," said N.L. Bishop, president of Jefferson College of Health Sciences, who is helping to coordinate the task force.

Details of who will be on the panel and how it will operate are still being worked out, Bishop said.

But one of the goals will be to embrace diversity both in the larger community and within the health care setting.

"We are always sensitive to our patients, who come from a variety of cultures and backgrounds," Bishop said.

Another potential topic for the task force will be the makeup of Carilion's workforce. Of the 11,206 employees, 12.8 percent are minorities.

The task force will report directly to Agee. "That's the level of importance it has," Bishop said.

A competitive advantage

Although Carilion is by no means the first employer in the area to offer domestic partner benefits, some hope its decision to do so will spur others to action.

"They are certainly a leader and a major employer," Mann said, "and I think to take that step, it shows the community what can be done."

In Western Virginia, 33 groups that offer coverage through Anthem Blue Cross and Blue Shield provide domestic partner benefits, according to Anthem spokesman Scott Golden.

Anthem, the largest health insurance provider in Virginia, has 2,800 such groups statewide.

Among the region's top employers that provide some kind of domestic partner benefits are Advance Auto Parts, Anthem, Wells Fargo, ITT Exelis, Kroger, Norfolk Southern Corp. and LewisGale Medical Center.

Details differ from company to company, and sometimes within the company.

At Norfolk Southern, for example, both same-sex and opposite-sex domestic partners are covered for salaried employees, of which there are about 530 in the Roanoke area.

However, the approximately 1,330 hourly employees work under nationally negotiated union contracts, which cover only legally married spouses, NS spokesman Robin Chapman said.

Advance Auto offers the benefits to same-sex couples; LewisGale makes them available to same-sex partners and to opposite-sex partners if at least one of them is 62 or older and meets Social Security criteria.

The LewisGale benefits are part of an HCA company-wide plan implemented in 2005.

Virginia Tech and the governments of Roanoke and Roanoke County do not provide the coverage, in accordance with state requirements.

An amendment to the Virginia Constitution, approved by voters in 2006, defines marriage as only between a man and a woman.

The amendment also prohibits state agencies and local governments from recognizing any status of unmarried couples that approximates marriage, such as civil unions or domestic partnerships.

The amendment applies directly to state government and to local governments when combined with earlier legal findings, according to the Human Rights Campaign.

"I think you'd be hard pressed to find any municipalities in Southwest Virginia that are offering coverage to domestic partners," said Carolyn Glover, director of human resources for Roanoke. "The state has not moved on this yet, so it's unlikely that local governments would want to do this first."

Those in the private sector, however, are free to offer the benefits. Many do as a way to attract a more diverse and qualified work force.

"That's how these things got started," said Doug Gray, executive director of the Virginia Association of Health Plans. "There was a competitive advantage to have it, and it morphed from there into a standard practice."

For businesses that are just now offering the benefits, he said, the real question is: "Why did it take so long?"

'Didn't see it coming'

At their waterside home near Smith Mountain Lake, where Roe and Mann live with a mixed-breed dog named Abbey and cats Frazier and Emma, they talked recently about the significance of their health care plan.

While they have signed other documents together, such as deeds and wills, this was the first to officially recognize their domestic partnership.

They are thinking about going one step further this summer, on the 20th anniversary of their first date, by getting married in a place that allows it, either Washington, D.C., or Massachusetts.

But for now, they are grateful to have through Carilion what many traditional married couples take for granted.

Despite the bite that taxes will take, Roe estimates they will save about $500 a year on the joint health coverage, in part because of how much Mann was paying under her previous plan.

The arrangement will also give Mann access to Carilion doctors she did not have before.

As for how long it took for them to get this far, Roe and Mann have different opinions.

Roe thinks domestic partner benefits should have come to the area sooner. Mann is impressed that it happened at all.

"I really didn't see it in my lifetime," she said. "For Roanoke, I just didn't see it coming."

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