On July 2, 2013, the Department of Health and Human Services (HHS) issued a final rule on coverage of certain preventive services under section 2713 of the Public Health Service Act, added by the Patient Protection and Affordable Care Act and incorporated into the Employment Retirement Income Security Act of 1975 and the Internal Revenue Code. Section 2713 requires coverage (without cost-sharing) of various preventive health services by group insurers. These services include women’s preventive health services and contraception, which is the focus of this final rule. This rule explains the process for religious employers and educational institutions to receive an exemption to the contraception coverage requirement. Religious organizations are nonprofit organizations and defined in the Internal Revenue Code. They may complete a self-certification form explaining their religious status and opposition to contraception. This allows them to exclude contraception from their health insurance coverage. Health insurance issuers of plans for these organizations must exclude contraception coverage from the group health insurance coverage and instead provide separate payments for contraceptive services. Issuers must also give notice to beneficiaries about the availability of separate payments for contraception and explain that the religious organization does not administer or fund contraceptive benefits itself.
The regulations also allow for financial support for contraception expenses for issuers of self-funded plans of exempt organizations. These issuers may pay a lowered Federally-facilitated Exchange user fee provided they give certain information to HHS, including their costs for contraceptive services for beneficiaries in health plans subject to the religious exemption. The final rule takes effect for plan years beginning on or after January 1, 2014, except for amendments to the religious employer exemption, which affect plan years beginning on or after August 1, 2014. The final rule can be found here.