August 1, 2011- Federal agencies and the U.S. Department of Health and Human Services (HHS) have announced the inclusion of preventive care services for women with no cost sharing–in a provision of PPACA. These interim rules apply to non-grandfathered medical plans and take effect with plan years beginning on or after August 1, 2012. For example, if your medical plan has a July 1, 2012 renewal, these preventive care rules would not apply until July 1, 2013. If your plan renewal falls on August 2, 2012, the PPACA provisions for women’s preventive services will be in effect.
Below is a brief summary of what must be covered under this provision without cost-sharing:
- Well-woman visits–Annually or more often if necessary
- Screening for gestational diabetes–During pregnancy
- DNA human papillomavirus testing–Every 3 years, if at least 30 years old
- Counseling for sexually transmitted diseases–Annually
- HIV counseling and screening–Annually
- Contraceptive methods and counseling–As prescribed, all FDA-approved methods
- Breastfeeding support, supplies and counseling–Coinciding with each birth
- Screening/Counseling for interpersonal and domestic violence–Annually
The rules apply to all group health plans, with the exception of Health FSAs or separate dental/vision plans. Any possible effect of Health Reimbursement Arrangements (HRAs) is not addressed in the provision.
Furthermore, the HHS, IRS, and Employee Benefits Security Administration have released an amendment that will give religious institutions the choice of whether or not to cover contraceptives in their employee benefits plan. In other words, churches, conventions or institutions with “exclusively religious activities” will have the option to not provide this preventive care coverage. This exemption is not available for individual health insurance policies.
Insurance carriers will likely have their own response to these provisions–in terms of an effect date for insurance policies, while remaining in compliance with regulation. Austin Financial Group will release updates and information as decisions are made by the various carriers.
Please contact Austin Financial Group or your dedicated AFG Account Manager with questions or concerns, at 248-594-5550 or smartsolutions@austinfg.com.
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For more information about the changing health care climate in light of the Affordable Care Act, look for information on our upcoming seminar, or contact us today at 248-594-5550 or at smartsolutions@austinfg.com.
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