Same-Sex Spouses and Domestic Partner Coverage in Group Health Plans

Document created by 1050210 on Nov 13, 2014
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Published Date: 07/28/2014


Pat; Rountree

By Pat Rountree


CAI's Advice & Resolution Team has recently received several inquiries from members asking whether they have the option to cover same-sex spouses and domestic partners under their group health plans. Although North Carolina does not recognize same-sex marriage (even if the marriage took place in a state where it was legal), employers have the option to define who will be covered under their group health plan, according to Lindsey Surratt, JD, Compliance Officer with Hill, Chesson & Woody.


Lindsey recommends that fully-insured employers work with their carrier to make sure the eligibility language in their group contract and certificates of coverage/member guides accurately reflect their intent regarding eligibility. If your current language states legal spouses may be covered, that could be ambiguous as to whether that includes legally-married same-sex spouses under federal law.


North Carolina employers who want to cover only legally-married opposite sex spouses still have that option, and should review the plan document language to see if it requires revision. Employers who want to cover domestic partners or legal same-sex spouses should work with their carrier to draft appropriate language to make sure they are included.


Lindsey cautions that employers with employees in multiple states will need to determine if there are any state discrimination laws in the states in which they do business that would require them to offer coverage to same-sex spouses if they also offer coverage to opposite sex spouses.