Supreme Court Decision on Same-Sex Marriage

Aetna recently notified brokers that their enrollment deadline has been extended for applicable members/spouses affected by the same-sex marriage ruling.  Check each carrier site for how they are applying the ruling to their own members, but they will likely have similar changes to the Aetna updates outlined below.

To summarize the ruling, on June 26, 2015, the U.S. Supreme Court decided that all states must license a marriage between two people of the same sex and honor marriages licensed in another state.  As a result of this ruling, Aetna said that "fully insured health plans offered by Aetna in all states now cover same sex spouses the same way they cover spouses of the opposite sex. "

What this means for Aetna members on insured plans:

  • Members who were legally married on or after June 26, 2015 will have 31 days from the date of marriage to enroll their same-sex spouses.
  • Members who were legally married prior to June 26, 2015 but were not allowed to enroll their same-sex spouses in their fully insured plan now have until August 28, 2015 to enroll their spouses.
  • There will be no special enrollment period for members who were married prior to June 26, 2015 who were allowed previously to enroll their same-sex spouse.
  • Members who miss an enrollment deadline, will need to wait for the next open enrollment period, or experience a qualifying event, before adding their spouse.

According to Aetna, what this means for your clients:

The changes outlined above only apply to insured plans.  Self-funded plans should consult with their legal counsel as they decide how to handle eligibility for same-sex spouses.
This ruling does not impact domestic partnership benefits.  If, however, a group wishes to make a change to domestic partnership benefits, and state law allows it, [Aetna] will make the change at renewal.
Groups may still have the option to choose whether they cover employee spouses, but if they cover some spouses, they must cover all.

Aetna encourages brokers to contact their Aetna Representative with any specific questions or for additional information.