Free Contraception For Employees at Exempt Employers
Employees can get free contraceptive coverage on employer plans, even if an employer is exempt from offering contraception for religious reasons.
Summary of How the Final Rules on Contraception for Religious Employers Work
Final rules issued by the Obama administration make it easier for religious employers to be granted an exemption from the mandate to provide contraception. Employers won’t have to arrange or pay for contraceptive coverage, but employees will be able to access free contraceptive services at no cost through a third party, as long as they maintain their employer plan.
To get the exemption employers must write a letter to Department of Health and Human Services stating their objection. HHS will then notify a third-party insurer of the company’s objection, and the insurer will provide birth control coverage to the company’s female employees at no additional cost to the company.
This rule applies to all religious employers (such as religious non-profits, religious hospitals, religious institutions of higher education, and religious employers like hobby lobby) but it does not apply to “places of worship”. Places of worship are still exempt from the mandate to provide contraceptive coverage.
“Women across the country should have access to preventive services, including contraception. At the same time, we recognize the deeply held views on these issues, and we are committed to securing women’s access to important preventive services at no additional cost under the Affordable Care Act, while respecting religious beliefs.” – HHS Secretary Sylvia Burwell
Below is a summary of how the rules differ for each employer type from HHS.Gov.
Final Rules for Religious Employers
Final rules issued by the Obama administration simplify the definition of “religious employer” in regard to the exemption from providing contraceptive coverage. This makes it easier for employers, primarily houses of worship, to understand if they meet the exemption or not.
The final rules also lay out the accommodation for other non-profit religious organizations – such as non-profit religious hospitals and institutions of higher education – that object to contraceptive coverage. Under the accommodation these organizations will not have to contract, arrange, pay for or refer contraceptive coverage to which they object on religious grounds, but such coverage is separately provided to women enrolled in their health plans at no cost. The approach taken in the final rules is similar to, but simpler than, that taken in the proposed rules, and responds to comments made by many stakeholders.
With respect to an insured health plan, including a student health plan, the non-profit religious organization provides notice to its insurer that it objects to contraception coverage. The insurer then notifies enrollees in the health plan that it is providing them separate no-cost payments for contraceptive services for as long as they remain enrolled in the health plan.
Similarly, with respect to self-insured health plans, the non-profit religious organization provides notice to its third party administrator that objects to contraception coverage. The third party administrator then notifies enrollees in the health plans that it is providing or arranging separate no-cost payments for contraceptive services for them for as long as they remain enrolled in the health plan.
The final rules provide more details on the accommodation for both insurers and third party administrators.
The final rules strike the appropriate between respecting the religious considerations raised by non-profit religious organizations and increasing access to important preventive services for women.
The final rules are available here: https://www.federalregister.gov/articles/2013/07/02/2013-15866/coverage-of-certain-preventive-services-under-the-affordable-care-act
For more information about today’s final rules visit: http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/womens-preven-02012013.html
Learn more about ObamaCare and contraception or learn more about how ObamaCare saved women $1.4 billion on birth control.
Beth Bintrim
I think that whoever decided that Planned Parenthood should be listed as a low-cost alternative when you don’t have contraception coverage has not actually been charged $100 for an office visit, not including all of the lab work. Because we had Highmark BCBS, but not contraceptive coverage, we only had to pay the negotiated, but not covered, $85 for the office visit.
Rebecca
Trying to get information about birth control for my daughter who works at a catholic hospital. The hospital will not cover birth control,!i called the number and it said our area isn’t covered. What are we supposed to do?
ObamaCareFacts.comThe Author
Religious employer health plans (houses of worship don’t have to provide coverage. For all other religious employers women are provided contraceptive coverage through a third party).
The page you are commenting on explains much of what we were able to find in our research. This page explains a bit more: https://obamacarefacts.com/obamacare-birth-control/
I am fairly certain HHS specifically is supposed to arrange the coverage, I wish I had a specific set of steps, I was very sure the employer was supposed to be pointing you in the right direction and I was very sure there was no exclusion based on region. Please update us if you find out more. I don’t like what I’m hearing here.
Cheryl Dykstra
Since religious organizations are denying so many contraceptives to female employees – even contraceptives (such as the pill) that serve multiple health care purposes – then why are they not forced to lower the premium costs of the female employees who are being denied full health care benefits? Why do the least paid employees, who are denied the most coverage, made to pay the same costs as their better paid male counterparts who enjoy full health care coverage and full benefits? There is nothing right, just, or fair about this! Anyone who is denied full health care benefits – especially those covering their vital reproductive organs – must have their premium costs lowered accordingly! Less Coverage MUST EQUAL Less Costs!
ObamaCareFacts.comThe Author
Under the current law an employer who denies contraceptive coverage must arrange for HHS to arrange for a third party to provide those services for free. If this isn’t happening at an institution (unless it be an actual church for the most part), they aren’t following the law.
Dorrie Tredway
How do I call out an organization for not following the law? I am getting the run around about how to get my birth control covered. I submitted a claim through their 3rd party insurer which my HR department told me to do and it was denied. The 3rd party said to call my prescription carrier so I called them and basically was told that I had to have my doctor call for a PA and if that is denied then my doctor can appeal it. This is complete obstruction to women’s reproductive rights. I am employed by a Catholic hospital. I think this is just awful. It is 2016 and women are still being oppressed. I have to use my insurance as my husband’s insurance kicked me off as I could get insurance through my employer. Funny thing is he is employed through a Jesuit organization and I got my birth control for free. Any suggestions on how I get my employer to comply with the law? Also, I did not receive any notification from my employer on how to get birth control coverage.
ObamaCareFacts.comThe Author
I really wish I knew. HHS is a good resource, but i’ve been pretty unclear how to report a number of ACA related shenanigans. I assumed there would be a general complaints department, but I haven’t found one.
Here is the official guidance on coverage from 2015: https://kaiserhealthnews.files.wordpress.com/2015/05/preventive-services-faqs-5-11-15.pdf
We do a plain english overview here: https://obamacarefacts.com/2015/05/12/hhs-issues-guidance-on-birth-control-mandate/
Also, keep in mind, there are some loopholes for certain types of religious employers (although catholic hospital is not one of them).
It can be really frustrating that employers want to control women’s healthcare, but I guess that is why change in politics is a hard-won battle and not a pushover.
Stacy
My religious employer (a huge hospital system) offers no birth control coverage nor any way for us to get it. So I guess they aren’t following the law? I just pay out of pocket with my primary care provider, but that isn’t right, if we should be getting access. I pay for health coverage through my workplace, it covers basically everything under the sun but birth control. Kinda funny, the only medication I use IS birth control. So I pay a large premium but don’t actually use it except for an annual physical.
It definitely costs the system so much more money to pay for prenatal care, birth, any complications, and obviously, a new little insuree on the insurance. But heaven forbid a woman desires to put off childbearing.
Michele
By that reasoning, men should pay less since they don’t pregnant- maternity is included. Older people should pay less since they can’t use the pediatric dental. Plus with the birth control, the employees can still get it with some form of letter stating the employer coverage does not cover it. Then I believe then the insurance carrier is then footing the bill for this birth control to be covered. Obmacare is just making everyone pay for everything whether you need it or not. It does not solve everything but is a feel good thing to say “affordable” coverage is available to everyone. And it is not affordable to everyone. Why did they not just address the issues at hand vs reinventing the wheel. Ironically, a lot of these religious organizations provided much help to those less unfortunate, and now they are being branded as evil since they don’t want to cover birth control?? Well people are dying from not getting cancer drugs, not from not getting birth control.
ObamaCareFacts.comThe Author
Not covering birth control is a choice, that is why HHS coordinates birth control coverage on behalf of individuals who want it despite what employers think. Coverage doesn’t discriminate by gender, because we are all in this together. No matter what our gender, we all come from the same place (literally).