Obama administration moves to clarify contraceptive coverage rules for self-insurers

New guidance outlines implementation proposals, calls for comments

The Obama administration on Friday issued draft proposals on how it would enforce federal contraceptive coverage rules for religious employers—including certain hospitals and universities—that offer self-insured group plans.

Federal officials in February said religious-affiliated organizations no longer were required to cover employees' birth control, instead announcing that it would require insurers to offer no-cost contraception directly to women.

In an Advanced Notice of Proposed Rulemaking, HHS, the Department of Labor, and the Department of the Treasury suggested three possible implementation strategies for the policy:

  • Requiring third-party administrators to cover the costs of contraception with revenues not connected with the religious organization;
  • Covering contraception costs by offering rebates to third-party administrators through the federal health reform law's reinsurance program; and
  • Having a separate insurance company offer contraceptive coverage to employees.

Stakeholders have 90 days to comment on the notice. The three departments intend to hold listening sessions to hear concerns and feedback prior to issuing final rules. According to the New York Times, administration officials expect to release the final rules for self-insured employers after the fall elections but before Aug. 1, 2013.

The administration on Friday also released a final rule governing student health insurance plans that affords students the same consumer protections as U.S. residents with individual market insurance (Pear, Times, 3/16; Feder, Politico, 3/16; Zigmond, Modern Healthcare, 3/16 [subscription required]; HHS release, 3/16).


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