Health Plans That Intend to Drop Contraceptive Coverage Must Notify Plan Participants

In response to the recent U.S. Supreme Court holding in Burwell v. Hobby Lobby that closely held, for-profit entities with religious objections to certain aspects of the Affordable Care Act's (ACA) birth control requirements could avoid the mandate by invoking the Religious Freedom Restoration Act, the Department of Labor has released guidance to address this eventuality. In the latest set of Frequently Asked Questions (FAQs) on the ACA's implementation, the DOL explains that group health plans offered by closely held, for-profit businesses that intend to cease providing all or some contraceptive coverage must notify plan participants within 60 days after the adoption of a modification or change to the plan's coverage.   

FAQ part XX advises: 

if an ERISA plan excludes all or a subset of contraceptive services from coverage under its group health plan, the plan's [summary plan description] must describe the extent of the limitation or exclusion of coverage. For plans that reduce or eliminate coverage of contraceptive services after having provided such coverage, expedited disclosure requirements for material reductions in covered services or benefits apply. 

The FAQ explains that in addition to this notice, "other disclosure requirements may apply, for example, under State insurance law applicable to health insurance issuers."  

The new FAQ was posted the same day Sen. Richard Durbin (D-IL) introduced the Preventive Care Coverage Notification Act (S. 2629), which would require for-profit corporations to notify job applicants in advance as to whether the employer did not intend to provide contraceptive coverage.

Information contained in this publication is intended for informational purposes only and does not constitute legal advice or opinion, nor is it a substitute for the professional judgment of an attorney.