Gender-Affirming Care and Group Health Plans: Insured vs. Self-Funded Plans, Applicable Federal Laws, State Law Issues

Course Details
- smart_display Format
Live Online with Live Q&A
- signal_cellular_alt Difficulty Level
Intermediate
- work Practice Area
ERISA
- event Date
Tuesday, June 17, 2025
- schedule Time
1:00 p.m. ET./10:00 a.m. PT
- timer Program Length
90 minutes
-
This 90-minute webinar is eligible in most states for 1.5 CLE credits.
This CLE webinar will provide employee benefits and ERISA counsel a detailed analysis of the current state of gender-affirming care and navigating the challenges faced by health plan sponsors and administrators. The panel will discuss applicable federal regulations that must be considered, including the ERISA preemption doctrine, Affordable Care Act (ACA), MHPAEA, and HIPAA, along with state law issues that may arise. The panel will also discuss current approaches to gender-affirming coverage and offer best practices for insured and self-funded plans and pitfalls to avoid.
Faculty

Mr. Bianchi is the Practice Group Leader of the firm’s Employee Benefits & Executive Compensation Practice. He advises corporate, not-for-profit, governmental, and individual clients on a broad range of executive compensation and employee benefits issues, including qualified and non-qualified retirement plans, stock and stock-based compensation arrangements, ERISA fiduciary and prohibited transaction issues, benefit-related aspects of mergers and acquisitions, and health and welfare plans. Mr. Bianchi is nationally renowned for his advice on the Affordable Care Act's impact on employers. He represented the Romney administration in connection with the historic 2006 Massachusetts health care reform act. Mr. Bianchi has testified before the Senate Finance Committee on the subject of health care reform. His many published works include the Bloomberg/Bureau of National Affairs Health Care Reform Advisor, a comprehensive work on the impact of the Affordable Care Act on employers and employer-sponsored group health plans. Mr. Bianchi is also the current chair of the Bloomberg Tax Compensation Planning Journal Advisory Board.

Ms. Raaii focuses her practice on employee benefits and matters related to health care reform, data privacy and HIPAA compliance, executive compensation, and health and welfare, cafeteria, 401(k), 403(b) and pension plans. She has experience counseling clients on regulatory compliance with the Affordable Care Act (ACA), Health Insurance Portability and Accountability Act (HIPAA), Employee Retirement Income Security Act (ERISA), Consolidated Omnibus Budget Reconciliation Act (COBRA), Internal Revenue Code and related state and federal laws affecting employee benefit plans. Ms. Raaii assists clients with drafting employee benefit plan documents and amendments and represents clients before the Internal Revenue Service (IRS), US Department of Labor (DOL) and Pension Benefit Guaranty Corporation with respect to plan qualification issues. She also advises clients on employee benefits diligence, design, implementation and transition matters arising from corporate and private equity mergers and acquisitions. Prior to joining McDermott, Ms. Raaii worked for the National Economic Council at the White House, where she implemented the Affordable Care Act and developed the DOL fiduciary rule with leaders from the Executive Office of the President, the Department of Labor, the Department of Health and Human Services and the Department of the Treasury. She previously worked with in-house attorneys and federal and state government relations professionals in the Leadership Development Program of a Fortune 500 global insurance and financial services corporation.

Mr. Kenkel focuses his practice on employee benefits and executive compensation matters. He has experience assisting clients with regulatory compliance matters related to tax-qualified retirement plans and executive compensation arrangements. Mr. Kenkel also regularly works with clients on benefits and compensation issues in connection with corporate transactions.
Description
Gender-affirming care has been a hot topic among federal and state regulators for the past couple of years. Plan sponsors and administrators struggle with navigating conflicting state laws while also trying to maintain compliance with applicable federal laws. Attorneys, plan sponsors, and administrators must have a firm understanding of applicable federal and state laws and current approaches to gender-affirming coverage.
On Jan. 28, 2025, President Trump issued an executive order that directs agencies and programs to work toward limiting some access to gender affirming care nationwide. This has caused confusion amongst agencies, plan sponsors, and administrators along with some disruption of services.
Listen as our panel discusses applicable federal regulations that must be considered for gender-affirming coverage, including the ERISA preemption doctrine, ACA, MHPAEA, and HIPAA, along with state law issues that may arise. The panel will also discuss current approaches to gender-affirming coverage and offer best practices for insured and self-funded plans.
Outline
- Current state of gender-affirming care and benefits
- Applicable federal laws
- Challenges for insured and self-funded health plans
- Recent state law developments and key issues
- Best practices for gender-affirming coverage
Benefits
The panel will discuss these and other key issues:
- Recent developments in gender-affirming benefits
- Applicable federal laws that must be considered by plan sponsors and administrators
- Key issues for both insured and self-funded health plans
- State laws restricting or limiting gender-affirming care
- Best practices and pitfalls to avoid for plan sponsors
Unlimited access to CLE courses
- CLE Live Webinars
- CLE On Demand Webinars
- All CLE Course Materials
Unlimited access to CPE courses
- CPE Live Webinars
- CPE On Demand Webinars
- All CPE Course Materials
Unlimited access to all our courses including:
- CLE Live Webinars
- CPE On Demand Webinars
- Professional Skills
Related Courses

Collective Investment Trusts and 401(k) Plan Investments: Guidance for Fiduciaries and Employee Benefits Counsel
Wednesday, April 16, 2025
1:00 p.m. ET./10:00 a.m. PT

Structuring Phantom Incentive Plans for Privately Held Corporations: Mechanics, Tax Obstacles, and Optimization
Thursday, April 10, 2025
1:00 p.m. ET./10:00 a.m. PT

Gender-Affirming Care and Group Health Plans: Insured vs. Self-Funded Plans, Applicable Federal Laws, State Law Issues
Tuesday, April 8, 2025
1:00 p.m. ET./10:00 a.m. PT
Recommended Resources
Getting the Most Out of BARBRI Resources
- Learning & Development
- Business & Professional Skills
- Talent Development
Navigating Modern Legal Challenges: A Comprehensive Guide
- Business & Professional Skills
- Career Advancement