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Sex-change spouse covered by health insurance

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in Compensation and Benefits,Human Resources

Does your health insurance or other benefit plan specifically state that it covers those who are married under Minnesota law? Then your policy terms probably apply in some unique circumstances—including when an employee is married to someone who has undergone gender reassignment surgery.

Recent case: Christine was born a male. However, later she changed her name and had surgery to become a woman. She then applied for a re­­placement birth certificate in Minne­­­sota and was issued one that said she was female. She then married her boyfriend, who worked for UPS.

After the wedding, Christine’s husband listed her as his spouse to receive coverage under UPS’ health plan. That plan said spouses were eligible dependents if they were legally married under Minnesota law.

Christine’s breast implant ruptured and she needed extensive surgery. That’s when the plan administrator discovered that she had been born a male. The coverage was cut and the couple sued. The plan countersued for the benefits it had paid out.

The court ordered the benefits re­­instated, pointing out that the couple were properly married under Minnesota law. This was not a case of same-sex marriage, the court explained, but one of simple interpretation of Minnesota marriage law.

Because Christine was classified as a woman, she was free to marry her boyfriend. If the health plan wanted to exclude sex-reassigned spouses from coverage, it should have stated so explicitly and not referenced Minnesota marriage law. (Radtke v. Miscellaneous Drivers and Helpers Union, No. 10-4175, DC MN, 2012)

Final note: Marriage laws are undergoing changes unprecedented in U.S. history. This is one area where you want to keep updated as your benefits plans may be impacted.

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