ERISA-Governed Health Plans That Cease Providing Contraceptive Services Must Disclose Changes

In response to the Supreme Court’s decision in Hobby Lobby v. Burwell, the Departments of Labor (DOL), Health and Human Services, and the Treasury have issued a frequently asked question (FAQ) that addresses disclosure requirements for plans that will cease providing coverage for some or all contraceptive services mid-plan year.

Plans subject to the Employee Retirement Income Security Act (ERISA) must disclose information relevant to coverage of preventive services, including contraceptive coverage. Specifically, the DOL’s longstanding regulations at 29 CFR 2520.102-3(j)(3) provide that the summary plan description (SPD) shall include a description of the extent to which preventive services, which includes contraceptive services, are covered under the plan.

As such, if an ERISA plan excludes all or a subset of contraceptive services from coverage under its group health plan, the plan’s SPD must describe the extent of the limitation or exclusion of coverage, according to the FAQ. For plans that reduce or eliminate coverage of contraceptive services after having provided such coverage, expedited disclosure requirements for material reductions in covered services or benefits apply. ERISA Sec. 104(b)(1) and 29 CFR 2520.104b-3(d)(1) generally require disclosure not later than 60 days after the date of adoption of a modification or change to the plan that is a material reduction in covered services or benefits.

In addition, other disclosure requirements may apply, for example, under state insurance law applicable to health insurance issuers.

For more information, visit http://www.dol.gov/ebsa/faqs/faq-aca20.html.

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