First a bit of background - ACA History

Starting in 2011, Departments issued regulations requiring non-grandfathered group health plans and carriers to cover all FDA-approved contraceptive methods, sterilization procedures, and related education and counseling. As a result, many of our clients that objected to these rules on faith-based principles, elected to remain grandfathered under the ACA. If you applaud this position, give credit to a company like Hobby Lobby for taking their case to the Supreme Court where a ruling was made to allow closely held for-profit companies that had religious objections to receive a similar accommodation that was previously granted to religious non-profits.

That Was Then … This .. Just In

On November 7th, 2018, the Departments of Health and Human Services, Treasury and Labor (the Departments) announced two final rules on display at the Federal Register, the provides exemptions for certain plan sponsors that do not wish to comply with the contraceptive coverage requirements that are part of the USPSTF A/B preventive care recommendations.

Among those entities allowed to exempt themselves are:

  • Churches, religious orders

  • Nonprofit organizations with religious/moral objections

  • For-profit entities that are not publicly traded, with religious/moral objections

  • For-profit entities that are publicly traded, with religious objections

  • Other non-government employers with religious objections

  • Non-governmental institutions of higher education with religious or moral objections

  • Individuals with religious or moral objections, with employer-sponsored or individual market coverage, where the plan sponsor and/or issuer are willing to offer them a plan omitting contraceptive coverage

  • Issuers with religious or moral objections, to the extent they provide coverage to a plan sponsor or individual that is also exempt

The final rules take effect 60 days after publishing in the Federal Register on November 7, 2018 or January 6, 2019. This means that those groups defined above have new found flexibility with their health plan coverage that does not require going to court or filing for accommodation. As a courtesy to our Holmes Murphy & Associate clients and readers of my BenefitU blog, we are providing a copy of the summary rules here.

For all of our clients that fall into the categories above, if one of the primary reasons you were remaining grandfathered was to maintain a safe harbor from the coverage requirements you were objecting to on moral or religious grounds, it might be time to reconsider your health plan’s grandfathered status.