Complaint Calls Airline Health Plans Unfair to Women

American Airlines Inc. discriminated against some employees by refusing to offer insurance coverage for birth control, Pap tests and infertility treatments, according to a charge filed Monday with the Equal Employment Opportunity Commission in Los Angeles.

Martina Alexander, a 37-year-old flight attendant from Riverside, said she filed the complaint after she sought coverage for an infertility problem.

Through correspondence with the Fort Worth-based company, Alexander said, she was informed that her health plan covered the impotence drug Viagra but not fertility treatments, Pap tests or birth control.

“That letter was a slap in the face,” Alexander said. “This was absurd, and it was unethical and immoral that they could treat women who work for American this way.”

American Airlines officials would not comment on the specific allegation because the company had not been notified of the complaint.

Spokesman Gus Whitcomb said contraceptives prescribed for birth control would not be covered under any of the health plans it offers its 110,000 employees worldwide. Contraceptives sometimes are prescribed for medical conditions. In those cases the prescriptions would be covered.

“What our health plans pay for are medications and procedures which are deemed medically necessary,” he said. “If any [prescription drug] is deemed to be medically necessary, then the health plan will pay for it.”

Whitcomb said Viagra, like all prescription drugs, is covered if deemed medically necessary. Infertility treatments may be covered by the airline’s health plans in some regions but not others, and Pap tests, which test for signs of cervical cancer, may be offered in certain plans that have wellness programs but not others, he said.

Since Jan. 1, 2000, California has required employers who offer health plans with prescription coverage to include prescription contraceptives, and bills with similar mandates have been introduced in Congress and several other states.

While there are no published federal court opinions addressing whether employers may exclude contraceptives from prescription drug plans, the EEOC took the position in December that the Pregnancy Discrimination Act forbids the exclusion.

Two cases challenging employers’ refusal to cover contraceptives have reached the federal courts. In Seattle, a lawsuit against a drug retailer recently was declared a class action, and in Minneapolis a judge ruled last week that a similar case against a commercial delivery service should go to trial.

“They are coming forward because it’s only in the past few years that it’s come to light how commonplace it is for employers to single out contraceptives for exclusion,” said Judy Appelbaum, vice president of the National Women’s Law Center in Washington. “The unfairness of that became glaring when Viagra was approved by the FDA and quickly got included in health plans and people said, ‘Hey, wait a minute.’ ”

There are only a few, mixed court decisions regarding infertility treatments, which men and women receive, and none on whether employers must provide Pap tests, according to several lawyers.

Alexander, who has worked for American since 1987, said she discovered contraceptives were not covered by her health plan in 1999. She said she wrote several letters and made telephone calls to American headquarters in an effort to get contraception, Pap tests and infertility treatments covered for all employees.

“I tried to change it at a corporate level, and they flat out said, ‘No,’ ” Alexander said. “And that’s when I decided I had to take it further.”

American self-funds its health plans, meaning claims are paid out of its budget, according to the company’s Nov. 8, 1999, letter to Alexander. To hold down costs, it said, American made the decision to cover “those expenses medically necessary to sustain life.”

Gloria Allred, the lawyer representing Alexander, said the suggestion that Viagra “is ‘medically necessary to sustain life’ is absurd. Many women . . . have died because of cervical cancer, which might have been detected by a Pap smear.”

EEOC legal counsel Ellen J. Vargyas said she could not discuss the complaint until the agency issued a ruling. But she said the commission issued its guidance decision in December because of the “fairly widespread” practice by employers of excluding contraceptive prescription coverage from drug plans.

If the EEOC determines Alexander has a valid complaint, the agency will give her permission to file a discrimination lawsuit in federal court. Federal law requires that all discrimination complaints against employers go to the EEOC first. If a lawsuit is filed, Allred said, she plans to ask the judge to make the case a class action on behalf of all similarly affected American employees.

Allred said she is investigating whether the new state law covers American.

The EEOC is expected to make its determination in 60 to 90 days, Allred said.