Society's growing awareness and acceptance of transgendered people -- along with employee affinity groups petitioning their companies to offer them health benefits -- is helping to drive a new trend in benefits offerings.
Employers are also fielding demands from other groups -- such as parents with autistic children -- that are seeking enhanced benefits amidst rising healthcare costs and an uncertain economy, says Darling.
"There's a constant demand for more of everything," she says.
To try and limit costs and ensure that procedures such as sex-reassignment surgery are indeed medically necessary, some companies impose conditions -- such as requiring a claimant to have lived as the opposite gender for a certain period of time and have the approval of more than one doctor -- before agreeing to cover reassignment surgery, she says. "This is really complicated stuff, with no easy answers," says Darling.
Darling, who in her previous career oversaw benefits for a global technology company, says in one instance a married employee at a company facility in Texas switched genders, prompting a discussion at headquarters as to whether the employee was still eligible for family medical coverage.
"They were no longer man and wife, so the question was, were they still married and eligible, under the existing rules, for dependent coverage?" she says. "Ultimately, we determined that since the State of Texas probably wouldn't officially recognize the person's gender change, then they were still married and, therefore, still covered."
Deena Fidas, the HRC's deputy director of corporate programs, says her organization's Corporate Equality Index has helped the cause of transgender benefits by encouraging companies to compete with one another in making themselves more LGBT-friendly.
"When we started the CEI in 2002, only 13 companies got top scores for workplace equality," says Fidas, who helps oversee the CEI. "This year, 190 companies scored 100 percent, with many others scoring in the high 90s. The report helps fuel the momentum among companies to do better."