New Exemptions from ACA’s Contraceptive Coverage Mandate | PA Benefit Advisors

On October 6, 2017, the Departments of Health and Human Services (HHS), Labor (DOL), and Treasury released new interim final rules to allow more employers to exclude contraceptive coverage from their group health plans. The new rules will be published in the Federal Register next Friday and take effect immediately. Read the Moral Exemptions and Accommodations for Coverage of Certain Preventive Services under the ACA and Religious Exemptions and Accommodations for Coverage of Certain Preventive Services under the ACA.

Background

The Affordable Care Act (ACA) requires that nongrandfathered group health plans provide 100% coverage for preventive care services that are specifically listed in federal guidance. Cost-sharing (deductibles, copays, coinsurance) is prohibited. The list of required preventive services, as developed by the US Preventive Services Task Force (USPSTF), the Centers for Disease Control (CDC), and others, includes prescribed contraceptives. Over-the-counter items are not covered by health plans.

Plans sponsored by several types of employers have been and continue to be exempt from the requirement to cover contraceptive services:

  1. Religious employers, such as churches and other houses of worship;
  2. Certain nonprofit religiously-affiliated employers, such as schools, hospitals, and charities affiliated with churches;
  3. Closely-held for-profit corporations based on the owner’s sincerely-held religious beliefs.

If 2 or 3 apply, the insurer or third-party administrator makes separate payments for the covered person’s contraceptive services.

What’s New

The new interim final rules expand the current exemptions so that any employer, including nonprofit organizations and for-profit companies, may claim a religious objection to covering contraceptives. Further, any employer, other than a publicly-traded company, may claim a moral objection to providing the coverage.

According to the HHS, 99.9% of women will be unaffected by the rules change. Since implementation of the ACA, only a small number of employers have raised religious or moral objections to covering contraceptives. Therefore, it appears the vast majority of employer-sponsored group health plans will continue to cover prescribed contraceptives as a preventive service.

Note that the federal rules change does not affect state insurance laws that may mandate coverage provisions.


Originally Published By ThinkHR.com

 

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