Compliance with the contraceptive coverage mandate under health reform is stayed until Aug. 1, 2013 for employers that fit into a slightly expanded enforcement safe harbor described by the Center for Consumer Information and Insurance Oversight (CCIIO) in an Aug. 15 memo.
Reform’s preventive care mandate requires plans and insurers to cover a host of preventive care goods and services — including female contraceptives prescribed by a physician — with no cost-sharing to the patient. Grandfathered plans do not have to comply with the preventive care mandate and an exemption for contraceptives exists for plans sponsored by qualified religious organizations, which were defined in Aug. 3, 2011 rules (76 Fed. Reg. 46621).
An expanded temporary enforcement stay for other organizations was established in a Feb. 10, 2012 memo. Under the memo, enforcement stays go to non-exempted, non-grandfathered organizations that:
- Operate and are organized as a non-profit entity.
- Historically don’t provide contraceptive coverage, because of religious beliefs.
- Communicate to participants that that contraceptive coverage will not be provided in the plan year starting on or after Aug. 1, 2012.
- Certify that they meet the above criteria.
This temporary enforcement safe harbor provides an additional year for these group health plans and group health insurance issuers (that is, until the first plan year beginning on or after Aug. 1, 2013). That memo remains in force.
The Aug. 15 description adds that the safe harbor is also available to non-profit organizations with religious objections to some but not all contraceptive coverage. Group health plans that applied for the exception but failed to meet the criteria in the Feb. 10, 2012 rules, and were thereby compelled to cover contraceptives may reapply for an enforcement stay.
They will not lose their ability to say they historically did not cover that contraceptive method if they show they took some action to try to exclude or limit that coverage, but failed as of Feb. 10
And the safe harbor may be invoked without prejudice by non-profit organizations that are uncertain whether they qualify for the religious employer exemption.
For additional information about health reform, see Thompson’s employee benefits library, including the Employer’s Guide to Self-Insuring Health Benefits.