The Patient Protection and Affordable Care Act (the “Act”) generally requires health insurance issuers and group health plans (other than grandfathered arrangements) to cover specified preventive health services without imposing any cost sharing requirements. This new mandate is included in § 2713 of the Public Health Service Act (“PHSA”), which is incorporated by reference into both ERISA and the Internal Revenue Code. As a result, the preventative care rules apply to group health plans of private sector employers, including tax-exempt employers. According to PHSA § 2713(a)(4), preventative services include:

“with respect to women, such additional preventive care and screenings … as provided for in comprehensive guidelines supported by the Health Resources and Services Administration …”

Please see full alert below for more information.