Below is the definition of a spouse and an eligible domestic partner as reflected in the medical plan Summary Plan Description (SPD)
Spouse – an individual to whom you are legally married or a Domestic Partner as defined in this section.
Domestic Partner – an individual of the same or opposite sex with whom you have established a domestic partnership as described below.
A domestic partnership is a relationship between a Participant and one other person of the same or opposite sex. Both persons must:
- not be so closely related that marriage would otherwise be prohibited;
- not be legally married to, or the Domestic Partner of, another person under either statutory or common law;
- be at least 18 years old;
- live together and share the common necessities of life;
- be mentally competent to enter into a contract; and
- be financially interdependent and have furnished documents to support at least two of the following conditions of such financial interdependence:
– they have a single dedicated relationship of at least 12 months duration;
– they have joint ownership of a residence; or
– they have at least two of the following:
♦ a joint ownership of an automobile;
♦ a joint checking, bank or investment account;
♦ a joint credit account;
♦ a lease for a residence identifying both partners as tenants; or
♦ a will and/or life insurance policies which designate the other as primary beneficiary.
The Participant and Domestic Partner must jointly sign an affidavit of domestic partnership provided by Human Resources upon your request.
There is coverage for mammograms, prostate exams and hysterectomies. Please keep in mind services may be subject to prior authorization and covered based on medical necessity.
Below are details of this benefit as reflected in the medical plan SPD.
Gender Dysphoria
Benefits for the treatment of Gender Dysphoria limited to the following services:
■ Psychotherapy for Gender Dysphoria and associated co-morbid psychiatric diagnoses as described under Mental Health Services in this section.
■ Cross-sex hormone therapy:
– Cross-sex hormone therapy administered by a medical provider (for example during an office visit) is provided under Pharmaceutical Products – Outpatient in the section.
– Cross-sex hormone therapy dispensed from a pharmacy is provided under Section 15, Outpatient Prescription Drugs.
■ Puberty suppressing medication injected or implanted by a medical provider in a clinical setting.
■ Laboratory testing to monitor the safety of continuous cross-sex hormone therapy.
■ Surgery for the treatment for Gender Dysphoria, including the surgeries listed below:
Male to Female:
– Clitoroplasty (creation of clitoris)
– Labiaplasty (creation of labia)
– Orchiectomy (removal of testicles)
– Penectomy (removal of penis)
– Urethroplasty (reconstruction of female urethra)
– Vaginoplasty (creation of vagina)
Female to Male:
– Bilateral mastectomy or breast reduction
– Hysterectomy (removal of uterus)
– Metoidioplasty (creation of penis, using clitoris)
– Penile prosthesis
– Phalloplasty (creation of penis)
– Salpingo-oophorectomy (removal of fallopian tubes and ovaries)
– Scrotoplasty (creation of scrotum)
– Testicular prosthesis
– Urethroplasty (reconstruction of male urethra)
– Vaginectomy (removal of vagina)
– Vulvectomy (removal of vulva)
Genital Surgery and Bilateral Mastectomy or Breast Reduction Surgery Documentation Requirements:
The Covered Person must provide documentation of the following for breast surgery:
■ A written psychological assessment from at least one qualified behavioral health provider experienced in treating Gender Dysphoria. The assessment must document that the Covered Person meets all of the following criteria:
– Persistent, well-documented Gender Dysphoria.
– Capacity to make a fully informed decision and to consent for treatment.
– Must be 18 years or older.
– If significant medical or mental health concerns are present, they must be reasonably well controlled.
The Covered Person must provide documentation of the following for genital surgery:
■ A written psychological assessment from at least two qualified behavioral health providers experienced in treating Gender Dysphoria, who have independently assessed the Covered Person. The assessment must document that the Covered Person meets all of the following criteria:
– Persistent, well-documented Gender Dysphoria.
– Capacity to make a fully informed decision and to consent for treatment.
– Must 18 years or older.
– If significant medical or mental health concerns are present, they must be reasonably well controlled.
– Complete at least 12 months of successful continuous full-time real-life experience in the desired gender.
– Complete 12 months of continuous cross-sex hormone therapy appropriate for the desired gender (unless medically contraindicated).
■ The treatment plan is based on identifiable external sources including the World Professional Association for Transgender Health (WPATH) standards, and/or evidence-based professional society guidance.
Prior Authorization Requirement
For Non-Network Benefits you must obtain prior authorization as soon as the possibility for any of the services listed above for Gender Dysphoria treatment arises.
If you fail to obtain prior authorization as required, Benefits will be reduced to 50% of Eligible Expenses.
Insurance Circular Letter No. 7 (2017)/Ins. Law §§ 3221(k)(6) and 4303(s), 11 NYCRR §§ 52.17(a)(35) and 52.18(a)(10)
New York Insurance Circular Letter No. 7 (2017), effect 04/19/17, says insurers must cover infertility treatment regardless of sexual orientation, marital status or gender identity.
- Background: Existing law mandates coverage for infertility. The mandate is based in part on the definition of infertility by the American College of Obstetricians and Gynecologists and American Society for Reproductive Medicine (ASRM) which provides that infertility is a disease, defined by the failure to achieve a successful pregnancy after 12 months or more of appropriate, timed unprotected intercourse or therapeutic donor insemination. Earlier evaluation and treatment may be justified based on medical history and physical findings and is warranted after 6 months for women over age 35 years.
- New Guidance: This letter provides that an issuer must provide coverage for infertility treatment using standards and guidelines no less favorable than those established and adopted by ASRM. ASRM’s definition of infertility does not distinguish between heterosexual individuals in a relationship or who are married, individuals in a same-sex relationship or who are married, single individuals, or based on gender identity. Therefore, every issuer must provide coverage for infertility treatment to any individual who meets ASRM’s definition of infertility when all of the other terms and conditions of the policy or contract are satisfied, regardless of the individual’s sexual orientation, marital status or gender identity. Issuers should also be mindful that, with respect to individuals in a same-sex relationship or single individuals, earlier treatment may be justified as permitted in the definition.
Summary: Summary of the Law
Assembly Bill 8354, effective 07/24/11, states same-sex couples should have the same access as others to the protections, responsibilities, rights, obligations, and benefits of civil marriage. A marriage shall be valid, regardless of whether the parties to the marriage are of the same or different sex. The intent of this law is that the marriages of same-sex and different-sex couples be treated equally in all respects under the law. Under this law, marriage to same-sex partners, rather than a different-sex partner cannot be shown unfairness to government treatment or legal status, effect, right, benefit, privilege, protection or responsibility relating to marriage, whether deriving from statute, administrative or court rule, public policy, common law or any other source of law
Provisions in the law outline the rights of a religious employer, denominational institution or organization, or any organization operated for charitable or educational purposes supervised or controlled by or in connection with a religious organization, the right to excludes coverage for same-sex marriage couples.
We are an independent free-standing law school. Ours is an urban campus with two academic buildings. We do not have online maps with our restrooms noted, in fact, we do not have online maps of any of our buildings. The restrooms are not noted on our directory signage.
In the main academic building, there are three restrooms with five stalls each, located on the 3rd, 6th, and 7th floors, which are labeled as “Restrooms.” Both male and female icons appear on this signage. In addition, there are six private, ADA-accessible single-toilet restrooms on the Basement, 3rd, 4th, 5th, 6th and 7th floors. These are labelled as “All-Gender Restrooms.” Restrooms on the 8th and 9th floor are labeled with male and female icons and the words “Self-Identified.”
In the second academic building, there are three restrooms available to people of all genders. All three are labelled “All-Gender Restroom.” One, located on the 20th floor, contains three stalls, one of which is ADA-accessible. In addition, on the 20th and 21st floors, there are two private, non-gendered ADA-accessible restrooms with a single toilet each.
Please note that if buildings cover our non-academic buildings, our residence hall does not have any restrooms in the two public spaces that have single stalls. There are ADA accessible restrooms in each of the identified women/men restrooms.
LGBT Advocacy Clinic
Funding is available, however, students have not requested it in the last 3 years.
This is the first year that we are providing diversity and inclusion training for staff and students. It is the second year of such training for faculty. The training does incorporate an LGBTQ+ curriculum, however, it is not robust. Improvements have been planned for future training. Our training will be conducted on an annual basis.
The Dean of the law school recently appointed an Associate Dean for Inclusion and Diversity. The responsibilities of the Associate Dean include working to ensure a safe, inclusive and welcoming environment for all students. The Associate Dean actively works to engage LGBTQ+ students, faculty and administrators.
We offer two questions on our application.
( ) Yes
( ) No
( ) Yes
( ) No