The Department of Health and Human Services clarified that all insurance companies must make available the option to cover same-sex spouses on their group and individual heath plans.
The new guidance does not require employers to offer coverage to spouses. However, if an employer does offer coverage to spouses, it must offer that coverage to same-sex spouses, and an insurer offering a non-grandfathered health plan must accept coverage of same-sex spouses. The insurer must offer the group or individual coverage on the same terms and conditions to same-sex spouses that is offered to opposite sex spouses. This is required by all insurance companies, even if the company is in a state that does not recognize same-sex marriage.