Some of the high lights…
The 76% figure sounds impressive for businesses that offers “trans-related treatment” but when you realize that the businesses only have to provide only one of the five criteria. When you look at the breakdown of what the companies provide, most of them pay only for medical leave and mental healthcare, while only ten percent cover surgery.
- 72% of CEI-rated employers provide employment protections on the basis of gender identity or expression, the highest figure to date. Perhaps one of the biggest success stories of any single criterion, growth in gender identity protections has gone from just 5 percent of rated businesses in the CEI 2002 to nearly three-quarters of all rated businesses (criterion 2a).
- 76% of this year’s rated businesses have written gender transition guidelines and/or cover gender identity as a topic of diversity training, up from 72 percent last year (criterion 2b). A total of 141 employers have transition guidelines, up from 115 last year.
- 63% include “gender identity or expression” or “gender identity” in their anti-harassment policies. [Compared to 81% that include sexual orientation]
Of the employers that met this criterion:
- 76% of this year’s rated businesses have determined that coverage is available for at least one of five categories of transgender-related treatment (criterion 2c). [Okay, this is where I have a problem with the CEI]
- 59 percent provide short-term leave for surgical procedures;
- 55 percent provide mental health benefits for counseling by a mental health professional (not limited counseling provided by Employee Assistance Programs);
- 24 percent provide pharmacy benefits for hormone therapy;
- 20 percent provide health benefits for medical visits and lab procedures related to hormone therapy; and
- 12 percent provide health benefits for surgical procedures.
Businesses balked at surgery because to include surgery in the insurance coverage cost a huge additional fee. When the city of San Francisco added surgery to its healthcare plan the premiums when way up, which discouraged businesses from adopting coverage for their trans-employees. However, it was then learned that the insurance companies were making millions because the insurance companies based their calculations on a trans-person have surgery yearly. San Francisco found that,
When the City and County of San Francisco made its employee insurance plans transgender-inclusive in 2001, it set up an additional per-employee per-month surcharge to offset the expected additional expenditures. By 2006, it had only spent $386,417 of the $5.6 million it had collected from this surcharge. It ended the surcharge completely:I have to add one thing in all fairness, the HRC is changing the way that they calculate the CEI, beginning next year the companies must cover all of the five criteria to receive a rating of 100% by 2012."Despite actuarial fears of over-utilization and a potentially expensive benefit, the Transgender Health Benefit Program has proven to be appropriately accessed and undeniably more affordable than other, often routinely covered, procedures."
— 2006 letter from San Francisco's Human Rights Commission