Posts Tagged: Preventive Care

Tri Agencies Update Preventive Care Regulations

in Affordable Care Act, Health Benefits

Today the Tri- Agencies (DOL, IRS and CMS) issued final preventive care regulations replacing prior interim rules and proposed regulations that applied to non-grandfathered health plans.  The final regulations apply to plans on the first day of the plan year that begins on or after September 14, 2015 (January 1, 2016, for calendar year plans).  These rules maintain the existing accommodations for religious organizations that object to providing contraceptive services and finalize the interim rule that provided for an alternative method for these entities to provide notice of their objection.  The same accommodations are extended to closely held for-profit entities as a… Continue Reading

New Preventive Care FAQs Contain Some Surprises

in Affordable Care Act, Health Benefits

New Affordable Care Act FAQs (Part XXVI, for those keeping track) were issued on May 11, 2015, addressing preventive care coverage.  Employers may be particularly interested in the guidance provided for coverage of contraceptives. In particular, the FDA has identified 18 specific methods of contraception, and at least one type within each of these 18 methods that must be covered with no cost-sharing.  For example, simply providing coverage for one type of hormonal contraception at no cost (such as birth control pills) is insufficient.  Instead, coverage at no cost must be provided for all 3 oral contraceptive methods (combined, progestin-only,… Continue Reading

IRS Affirms HDHP Preventive Care Benefits

in Affordable Care Act, Health Benefits

This morning the IRS issued Notice 2013-57 confirming the extent of preventive care benefits that can be offered under an HDHP with no deductible. Generally, under the health savings account rules, a high deductible health plan (HDHP) may not provide benefits for any year until the deductible for that year is satisfied. However, Code Section 223(c)(2)(C) provides a safe harbor for the absence of a preventive care deductible. Prior IRS guidance in 2004 set forth safe harbor rules that established the parameters of the preventive care exception for HDHPs. Under those rules annual physicals, well-child care, immunizations and other screenings… Continue Reading

Preventive Care Guidance Released

in Affordable Care Act

This afternoon the agencies issued additional ACA guidance in the form of frequently asked questions. This twelfth set of frequently asked questions addresses a number of issues under the preventive care contraceptive requirement. This requirement only applies to non-grandfathered plans. The guidance confirms that all FDA-approved contraceptives must be provided without cost sharing under the preventive care requirement, not just oral contraceptives as some have suggested. But, more importantly, the guidance also addresses the generic and brand-name drug question with respect to contraceptives. In this regard, the guidance provides that plans may cover a generic contraceptive drug without cost-sharing and… Continue Reading