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Final Rules on Coverage of Contraceptives

July 10, 2013

Final rules under the Affordable Care Act (ACA) affirm that nonprofit religious hospitals and institutions of higher education that object to providing contraceptive coverage for employees or students on religious grounds will not be required to pay for contraceptive coverage. Such coverage must be made available to women enrolled in their health plans through a third-party administrator, at no cost to the institutions. The final rules chiefly adopt the proposed regulations published earlier this year.

The ACA requires non-grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage to provide benefits for certain women's preventive health services without cost sharing. Included in the preventive health services must be all Food and Drug Administration (FDA)-approved contraceptive methods, sterilization procedures, and patient education and counseling for women with reproductive capacity.

Certain religious-affiliated employers, primarily houses of worship and religious orders, are exempted from this requirement and may exclude contraceptive coverage from their health plans; the Act provides a limited exemption to certain religious organizations. The religious exemption, however, does not extend broadly to private employers, such as religiously affiliated colleges and universities, that oppose providing contraception coverage on religious grounds.

The final rules, issued by the Department of Labor, the Internal Revenue Service, and the Department of Health and Human Services, lay out the accommodations for these "non-exempt" organizations, such as nonprofit religious hospitals or church-related higher education institutions that object to providing contraceptive coverage.

The final rules take a similar but more simplified approach than the proposed rules and respond to many stakeholder comments. With respect to an insured health plan, including student health plans, the religious institution or organization will provide notice to its insurer that it objects to contraception coverage. The insurer then notifies enrollees in the health plan that it is providing them separate, no-cost payments for contraceptive services for as long as they remain enrolled in the plan.

With self-insured plans, the religious institution or organization provides notice to its third-party administrator that it objects to contraception coverage. The third-party administrator then notifies enrollees in the health plans that it is providing or arranging separate, no-cost payments for contraceptive services for as long as they remain enrolled in the plan.

Nonprofit religious institutions and organizations must provide to their insurer or third party administrator EBSA Form 700 certifying that the organization qualifies for an accommodation. Religiously affiliated institutions have until January 1, 2014, to provide contraception coverage (extended from the previous deadline of August 1, 2013). 

Contact

Mary Bachinger
Director, Tax Policy
202.861.2581
E-mail