US Office of Personnel Management limits Federal Employees Health Benefits coverage for gender transition procedures
Change
The US Office of Personnel Management issued Plan Year 2026 guidance allowing Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) plans to exclude coverage for certain sex-rejecting (gender transition) procedures while requiring coverage for specified counseling services and exceptions processes for individuals already undergoing treatment.
Why it matters
The Equal Employment Opportunity Commission (EEOC) upheld OPM's authority to set coverage limits, removing a legal barrier to exclusions of specified gender transition procedures. This requires federal health carriers to apply the Plan Year 2026 exclusions and implement the counseling and exceptions processes OPM specified.
Implications
- • Federal health carriers participating in the Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) programs must implement Plan Year 2026 exclusions for certain sex-rejecting (gender transition) procedures as directed by the US Office of Personnel Management.
- • Federal health carriers must provide the counseling services and maintain exceptions processes for individuals already undergoing treatment in accordance with OPM's Plan Year 2026 guidance.
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Source
Topics
Governance Policy & Regulation Compliance Public Health Healthcare Systems