Further Guidance Issued on Contraceptive Coverage

Ed MacConnell

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… Read More

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Aetna: Transparency in Coverage Rule Update

Ed MacConnell

The Transparency in Coverage rule requires health plans and insurers to disclose pricing information via MRF by July 1, 2022. Health plans must generate two MRFs that contain Negotiated rates for in-network providers Billed charges and allowed amounts paid for out-of-network providers  We’ll publish this information on Aetna.com on July 1, 2022 for fully insured (51-100) and small group Aetna Funding AdvantageSM (2-100) groups. By posting the MRFs for small small group Aetna Funding Advantage clients, we’re taking work off their plate. Aetna will update the files each month and this link will remain active with the most up-to-date information.

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