Same-Sex Couples Health Insurance

Most employees get their health insurance through the companies they work for. This is a great way to get affordable health insurance. They can also wait for the annual “open enrollment” and add a family member or a dependent to their plan. However, if they get married or have a child, they can add them to their plan right away.

But how would these rules apply to same-sex couples? Same-sex marriages may be allowed in some states but they are not recognized by the federal government. If gay employees get married, are they allowed to add their new spouse to their health plan?

There are no easy answers when it comes to dealing with the financial issues concerning same-sex couples. This is no exception.

Most states do not recognize same-sex marriages. Same-sex couples living in these states may be offered domestic partner benefits if they want to add a new spouse or partner.

“Many companies do allow same-sex couples to add their partners if it is a recent union, they may be permitted to do so midyear,” according to Todd Solomon, a partner in McDermott Will & Emery. “However, some employers will only allow workers to add their partner’s name during the open enrollment.”

In short, it is the company’s decision to give same-sex couples health insurance.

Some states like New York, Iowa, Vermont, Massachusetts, New Hampshire, and Connecticut do allow same-sex marriages. It is easier to obtain coverage for a same-sex spouse in these states because they are treated exactly the same as heterosexual married couples under state law. Therefore, state workers and private company employees are eligible for spousal coverage.

However, the state law does not say when a company is required to let same-sex couples enroll their partners, Mr. Solomon said. “State law can require same-sex spouses to be covered under an insurance plan, however, it does not dictate when that enrollment should occur.”

This decision will probably depend on your company’s policies for same-sex marriages, which is often based on federal rules. In general, an employee must experience a qualifying life event like a marriage or the birth of a child in order to add a family member. This is because most health plans that allow employees to pay for coverage with pre-tax money (cafeteria plan) are governed by a section of the Internal Revenue Code (IRS), according to Mr. Solomon.

The IRS only recognizes marriages between heterosexual couples, therefore, these rules are not applicable. Perhaps this is the same reason why lesbian and gay employees are not allowed to use pretax dollars to pay for their spouse’s or domestic partner’s coverage, same goes for employees with opposite-sex domestic partners (although they can always choose to get married). Finding health insurance coverage is not the same for heterosexual couples and gay or lesbian couples

This means that employers are not controlled by the qualifying event rules. “The life event rules do not apply automatically to same-sex couples, it is up to the employers to decide if he wants to operate the plan that way,” said Mr. Solomon. “The number of companies trying to operate their enrollment procedures for same-sex couples the same as heterosexual couples are increasing.”

Health insurance policies may vary for same-sex couples based on state law and employer guidelines, making it essential to understand the specifics of a health insurance company’s health plan when seeking coverage.