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If your business provides a self-funded health insurance plan to its employees, that health plan covers “medically necessary” services, and you’re not keen on defending sex discrimination claims, then keep reading.
Yesterday, the Eleventh Circuit Court of Appeals affirmed a lower court ruling that an employer cannot exclude coverage for gender-affirming care under its employee health insurance plan.
That health plan covered “medically necessary” services, such as surgery, when a “significant functional impairment and the procedure can be reasonably expected to improve the functional impairment.” The employer sets the benefit terms, decides changes to the health plan, determines member deductibles