Smart Benefits: Two Regs Issued on Contraceptive Coverage

Smart Benefits: Two Regs Issued on Contraceptive Coverage

Two regulations on contraceptive coverage were recently issued by the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Treasury that impact closely held for-profits and religious non-profits.

• Proposed regulations on how certain closely held for-profit organizations can exclude some or all contraceptive coverage. Following the June 20 Supreme Court decision in the Hobby Lobby case that ruled closely-held, for-profit corporations can’t be required to cover contraceptives that violate the owners’ religious beliefs, the proposed regulations would allow certain closely held for-profit organizations to opt out of providing contraceptive coverage. In these situations, insurers or TPAs would provide contraceptive coverage at no cost, the same way they currently do for religious non-profit organizations that opt out of contraceptive coverage.

The proposed regulations also seek input on how to define a closely held for-profit organization that would be eligible to opt out. Two alternative proposed definitions are:

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• Not publicly traded, and ownership is limited to a certain number of owners; or

• Not publicly traded, and a minimum percentage of ownership is concentrated among a certain number of owners

A 60-day comment period for input on the proposed regulations is now open.

• Interim final regulations about eligible organizations’ communication for opting out of contraceptive coverage. Since some religious non-profit organizations such as charities, hospitals and schools have objected to signing the current self-certification form required to opt out of providing contraceptive coverage, the interim final regulations allow eligible organizations to notify HHS in writing of their objection to contraceptive coverage rather than using the form. Once HHS receives this information, HHS (or the DOL for self-funded plans) will notify the insurer or TPA.

Eligible organizations can still choose to use the self-certification form.

Amy Gallagher has over 21 years of healthcare industry experience guiding employers and employees. As Vice President at Cornerstone Group, she advises large employers on all aspects of healthcare reform, benefit solutions, cost-containment strategies and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, and is often quoted by national publications on the subject matter. Locally, Amy is a member of SHRM-RI, the Rhode Island Business Group on Health, and the Rhode Island Business Healthcare Advisory Council.