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Health Care Reform Mandates: Women's Preventive Health Care
07/10/2012

Now that the dust has settled some on the Supreme Court's decisions regarding health care reform (see our prior coverage here and here), it's time to begin thinking about some of the new mandates that are coming online in the next few weeks and months. First up: coverage of women's preventive-health-care services by non-grandfathered plans, which may be required as soon as August 1, 2012.

Although some of the regulatory guidelines on this mandate were released as recently as February and March of this year, it seems like an eternity ago with all that's happened in the meantime. So here's a refresher.

  • For plan years beginning on or after August 1, 2012, non-grandfathered plans are required to cover women's preventive-health-care services without cost sharing, as part of the plan's general coverage of preventive-care services.
  • The services required to be covered are based on guidelines issued by the Health Resources and Services Administration (HRSA). They include: (1) well-woman visits; (2) screening for gestational diabetes; (3) breastfeeding support, supplies, and counseling; and (4) all FDA-approved contraceptive methods and sterilization procedures.
  • Certain religious employers are exempt from the requirement to cover contraceptive services, but the exemption is a narrow one. For this purpose a religious employer is one that (1) has the inculcation of religious values as its purpose; (2) primarily employs persons who share its religious tenets; (3) primarily serves persons who share its religious tenets; and (4) is a non-profit organization that is exempt from the requirement to file Form 990 because it is either a church, an integrated auxiliary of a church, a convention or association of churches, or an exclusively religious activity of a religious order.
  • Non-profit organizations that do not qualify as "religious employers" (as described above) but object on religious grounds to covering contraceptive services have a one-year safe harbor from enforcement of this requirement, meaning they are not required to begin complying until their first plan years beginning on or after August 1, 2013. The safe-harbor is available only if (1) the organization has not provided contraceptive coverage at any time on or after February 10, 2012 because of the religious beliefs of the organization; (2) participants in the organization's health plan are notified (using a required form) that contraceptive coverage will not be provided during the first plan year beginning on or after August 1, 2012; and (3) the organization self-certifies that it satisfies the requirements for the safe harbor and documents that self-certification in accordance with the safe-harbor guidelines.
  • The government is continuing to work on regulations that would provide an alternative means of compliance with the requirement to cover contraceptive services for organizations that object on religious grounds to providing that coverage.
 


Editors
Don Berner Image
Don Berner, the Labor Law, OSHA, & Immigration Law Guy
Boyd Byers Image
Boyd Byers, the General Employment Law Guy
Jason Lacey Image
Jason Lacey, the Employee Benefits Guy
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