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Life Health > Health Insurance

Hawaii Asks Health Plans to Show Gender Transition Benefits on Web

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What You Need to Know

  • The Hawaii insurance commissioner sent his memo to HMOs and mutual benefit societies as well as to health insurance companies.
  • He says descriptions of benefits related to gender identity should descriptions of benefits related to gender transition.
  • The new benefits descriptions are supposed to go up before 2022 plans come to life.

Insurance regulators in Hawaii want to help people in the state compare health plans’ gender transition benefits.

The effort may mean that agents, brokers and other benefits advisors in Hawaii — and in any states that follow Hawaii’s lead — will have one more coverage detail to explain to clients.

The Memo

Colin Hayashida, Hawaii’s insurance commissioner, put the state’s gender transition benefits disclosure guidelines in a new memo.

Hayashida asked health coverage providers to post clear and complete gender identity benefits summaries on their websites.

The updates should include descriptions of any coverage for services related to gender transition, Hayashida wrote.

Hayashida addressed the memo to health maintenance organizations, and to any mutual benefit societies that provide health coverage, as well as to health insurance companies.

The gender identity benefits descriptions should go up on the web “as soon as possible and at the latest, prior to the effective date of plans for plan year 2022,” Hayashida said.

Hayashida noted that the statutes of Hawaii prohibit health plans from discriminating against people with respect to either participation or coverage, based on actual or perceived gender identity.

He also cited a recent move by the U.S. Department of Health and Human Services to change how HHS interprets an Affordable Care Act provision that prohibits discrimination on the basis of sex. HHS now says it believes the term “discrimination on the basis of sex” includes “discrimination on the basis of sexual orientation” and “discrimination on the basis of gender identity.”


In the past, some people referred to gender transition procedures as “sex change” procedures.

The Health Industry Collaboration Effort — a volunteer-led health insurer consortium that includes representatives from many major health coverage providers, including Aetna, Aetna, Cigna, Humana, UnitedHealth and Centene’s Health Net unit — suggested, in a communications tool kit approved in 2019, that use of the term “sex change” is exclusionary, and that use of terms such as “gender affirming surgery” and “gender transition” is more sensitive.

Honolulu (Photo: Shutterstock)


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