On July 28, 2022, the Departments of Labor, Health and Human Services and the Treasury (collectively, “the Departments”) issued FAQ Part to clarify protections for contraceptive coverage under the Affordable Care Act (the “ACA”). In January 2022, the Departments had issued guidance on the ACA Preventive Care Mandate, including contraception.

The Departments issued FAQ Part 54:

  • In response to reports that individuals continue to experience difficulty accessing contraceptive coverage without cost sharing;
  • To clarify application of the contraceptive coverage requirements to fertility awareness-based methods and to emergency contraceptive; and
  • To address federal preemption of state law.

Employers sponsoring non-grandfathered group health plans should review the various preventive care requirements effective for their upcoming plan years. Such coverage must be provided in-network, without cost-sharing.

Fully insured health plans. Carriers are generally responsible for compliance and should include these benefits as applicable.

Self-funded health plans. Discuss with TPAs to ensure coverage is in effect for plan years that begin on or after the applicable effective dates.

As always, please contact your Total Benefit Solutions, Inc health insurance specialists with any questions or concerns at (215)355-2121.