Increasing numbers of people are identifying as LGBTQ+, particularly among younger generations now entering workplaces, but their needs are often underserved in the design and administration of benefit plans. Employers and plan sponsors that proactively make their plans more inclusive—from enrollment forms to health supports, treatments and medications—may be able to minimize plan costs and maximize the health and abilities of LGBTQ+ members.

“From the initial contact with the plan to the specific benefits offered, LGBTQ+ people find barriers that do not exist for the straight and cis people for whom the schemes were designed,” wrote Allison Tremblay in “Designing Inclusive Benefit Plans for LGBTQ+ Members” in the January/February 2021 issue of Plans & Trusts.

She suggested that employers review their plans for inclusivity, assess their benefit design, be aware of health disparities among member populations and be proactive in addressing the needs of LGBTQ+ members.

Review Your Plan

Tremblay, who is a labour, employment and human rights lawyer as well as a partner with Victory Square Law Office (VSLO) in Vancouver, British Columbia, wrote that plan sponsors should review their plans to make sure that enrollment forms are inclusive and that systems can correctly record information in order to accurately address members and their needs.

Too often, paperwork for new hires leaves LGBTQ+ employees feeling unseen or invalidated. Examples of exclusionary benefit forms include only having a box for “male” or “female” gender identification or requiring a legal name but not leaving room for a preferred name, which can be especially problematic for employees who are transitioning genders.

Tremblay suggested that plan sponsors ask themselves the following questions to better serve their entire membership.

• Are our forms inclusive?
• Are our systems designed to correctly record the information gathered on the forms?
• Do administrators have access to the information they need to accurately address members and their needs?

Assess Your Benefit Design

Administrators also should review their plan design to see if there are ways to remove barriers on certain support services, treatments and/or medications that are unnecessarily limited for the LGBTQ+ community.

“The possibility of discrimination does not end at the enrollment stage. LGBTQ+ people often have different and greater health needs than straight, cis people,” Tremblay wrote.

Common exclusions in benefit plans that disproportionately affect LGBTQ+ members include oral contraceptives, which can be used as hormone replacement therapy by transwomen and intersex people, as well as reproductive support and fertility treatments that may be necessary for queer couples.

Tremblay noted that many, though not all, transgender people wish to have medical treatments to change their physical appearance to better match their true gender. Doing so has been found to provide both psychological and physical health benefits. But most plans would exclude such treatments as cosmetic or not medically necessary instead of a vital part of a member’s overall health.

Be Aware of Health Disparities

“Studies have demonstrated that LGBTQ+ people generally have worse health and health outcomes. The risk is particularly high for transgender people, who often have difficulty accessing quality care and who are at particularly high risk for mental health concerns,” Tremblay wrote.

“A study conducted by Trans PULSE Canada in 2020 revealed that 45% of trans and non-binary survey respondents said they had an unmet health need in the past year, compared with just 4% in the general population. This can increase the length and severity of illness as well as the ultimate cost of treatment when the person eventually obtains medical care.”

Plans that help members receive the care they need when they need it can help to maximize a member’s ability to remain productive in the workforce while also minimizing costs to the plan.

Related Reading: Three Important Steps on Your Diversity and Inclusion Journey

Be Proactive and Inclusive

“For current employees, access to necessary medical care is a key element of worker health and contentment,” Tremblay wrote. “For modern, inclusive administrators and plan sponsors, being proactive about the needs of the LGBTQ+ community makes sense. At the very least, amending the enrollment forms is an inexpensive and quick way to signal to LGBTQ+ people that their needs have been considered.”

Being proactive about the needs of LGBTQ+ plan members goes beyond legal questions of human rights. An inclusive plan that allows for necessary medical care can be a valuable recruitment and retention tool and can improve employee health and job satisfaction.   

Robbie Hartman, CEBS
Editor, Publications, for the International Foundation

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