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If you pay your own premium or a portion of the premium, that premium should only increase if you add a spouse to your coverage, regardless of their gender. If your premiums are paid by your employer, then your cost will continue to be zero.

If you are an employer who provides coverage to the spouses of employees, then the overall cost of that benefit will increase anytime a spouse is added, regardless of the gender of the spouse. It is important to note that you cannot legally deny the benefit on the basis of sexual orientation in the states where same-sex marriage has been legalized.

If you are an insurance provider, then your revenues might increase somewhat and your costs might decrease somewhat, as happens when more people are insured.

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