Reform Alert - News from the Blues' Office of National Health Reform

Additional component added to final rule on preventive health services for religious employers

Feb. 17, 2012

In August 2011, the Department of Health and Human Services issued an interim final rule requiring most health insurance plans to cover preventive services for women, including FDA-approved forms of contraception, without cost-sharing beginning with plan years on or after Aug. 1, 2012.

On Jan. 20, 2012, HHS announced that it would allow some groups to delay their compliance with the contraceptive services mandate. Nonprofit employers who, based on religious beliefs, do not currently provide contraceptive coverage in their insurance plan, will be provided an additional year, until Aug. 1, 2013, to comply with the new regulation. This additional year, which is referred to as a temporary enforcement safe harbor, is available to religiously-affiliated groups, such as hospitals, charities and universities that currently do not provide contraceptive services, and allows them more time and flexibility to adapt to the new rule. Employers must certify that they qualify for the delayed implementation. In addition, these employers must provide notice to employees informing them that contraceptive services are available at certain sites, including community health centers, public clinics and hospitals with income-based support.

Please note, those employers that meet the tax code's narrow definition of religious employer will be allowed an exemption from the contraceptive mandate.

Recently, the federal government issued final regulations regarding contraceptive methods and counseling. These regulations acknowledge the safe harbor and note that while it is in place, the government will work with stakeholders to develop an alternative mechanism to allow employees of non-exempted religious employers to access contraceptive coverage from their carrier without cost sharing.

This intention has not been finalized, and important details were not described in the federal government's announcement, so it is unclear when and if these future regulations will impact Blue Cross Blue Shield of Michigan and Blue Care Network.

Blue Cross Blue Shield of Michigan and Blue Care Network will continue to monitor the regulations to determine how to best assist our group customers. Updates will be provided as soon as they become available.

The information on this website is based on BCBSM's review of the national health care reform legislation and is not intended to impart legal advice. Interpretations of the reform legislation vary, and efforts will be made to present and update accurate information. This overview is intended as an educational tool only and does not replace a more rigorous review of the law's applicability to individual circumstances and attendant legal counsel and should not be relied upon as legal or compliance advice. Analysis is ongoing and additional guidance is also anticipated from the Department of Health and Human Services. Additionally, some reform regulations may differ for particular members enrolled in certain programs such as the Federal Employee Program, and those members are encouraged to consult with their benefit administrators for specific details.