Final Rule Regarding Preventive Services Under ACA

Franczek P.C.
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The Department of the Treasury, DOL, and Department of Health and Human Services (HHS) issued final rules regarding coverage of certain preventive services required to be provided under ACA without cost sharing by non-grandfathered group health plans. The final rules combine provisions from three sets of rulemaking actions: two interim final regulations and one proposed regulation. Amongst other things, the final rules allow eligible employers that have a religious objection to providing contraceptive coverage to receive an accommodation by either filing EBSA Form 700 or notifying HHS in writing of the objection. An eligible employer for this purpose is an organization that (1) opposes providing coverage for contraceptive items or services on account of religious objections, (2) is organized as a nonprofit entity holding itself out as a religious organization or is a closely held for-profit entity that has adopted a resolution establishing its objections on account of the owner’s sincerely held religious beliefs, and (3) selfcertifies that it is eligible for an accommodation. The DOL and HHS will notify insurers and third party administrators of an organization’s objection and participants in the plans can receive separate payments for contraceptive services, with no additional cost to the participant or employer organization. The written notice to HHS must include the name of the organization and the basis on which it qualifies for an accommodation. These final regulations are effective September 14, 2015.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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