Women’s Preventive Services Coverage and Non-Profit Religious Organizations
Most health plans are required to cover certain recommended preventive services, including certain women’s preventive health services, without charging cost sharing, like a co-pay, co-insurance, or deductible. The independent Institute of Medicine (IOM) provided recommendations to the Department of Health and Human Services (HHS) regarding which preventive services help keep women healthy. The IOM recommendations included covering all FDA-approved contraceptive services for women with child-bearing capacity, as prescribed by a provider, because of the health benefits for women that come from using contraception. In fact, nearly 99 percent of women in the United States have relied on contraceptive services at some point in their lives, but more than half, between the ages of 18 and 34, have struggled to afford it. Under Affordable Care Act (ACA) rules, starting in 2012, women enrolled in most health plans and health insurance policies (non-grandfathered plans and policies) are guaranteed coverage for recommended preventive care, including all FDA-approved contraceptive services prescribed by a health care provider, without cost sharing.
Seeking to end a long-running controversy, federal regulators finalized proposed rules to enable employees of nonprofit religiously affiliated organizations, such as hospitals, and closely held private corporations to obtain coverage for prescription contraceptives, even if their employers object.
Like the earlier rules proposed nearly a year ago by the U.S. Department of Health and Human Services, under the final HHS regulations, religiously affiliated organizations would provide written notification to HHS of their objections to the coverage.
- For nonprofits with an insured plan, HHS then would notify the insurer, with the insurer becoming responsible for providing the coverage.
- For self-funded organizations, the U.S. Department of Labor would notify the organization’s third-party health plan administrator, with the TPA then arranging the coverage.
- The insurers or TPAs would pay for the coverage.
- Read HHS’ press release here
- Read CMS’ Fact Sheet
- Read the DOL/EBSA update, 7/10/2015
- Final Rules (112 pages)