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22, May 2022
Proposed Rule on Recommended Prevention Services Policy – Public Input Required

The Obama administration released proposed rules that are open for public comment on contraceptive coverage without cost sharing under the Health Care Act. Proposed rules offer women coverage for preventive care, which includes contraceptive services without co-pays. They also take into account the concerns of religious organizations.

This Notice of Proposed Rule Making reflects the public feedback from the Advance Notice of Proposed Rule Making issued in March 2012. These proposed rules can also be viewed by the public through April 8, 2013.

Kathleen Sebelius, Secretary of Health and Human Services, said that the administration was taking the next step to provide women in the country with preventive care coverage at no cost. She also acknowledged religious concerns. To achieve these goals, we will continue to collaborate with faith-based and women’s groups, insurance companies, and other organizations.

These proposed rules outline how non-profit religious institutions, such as religious hospitals and higher education institutions, can get accommodation to provide contraceptive coverage to their enrollees with separate coverage. There are no co-pays and no cost to them.

These religious groups would notify their insurer about any insured plans, even student health plans. The insurer would notify the enrollees that they are providing no-cost contraceptive coverage through individual health insurance policies.

These religious groups would notify their third-party administrator about self-insured and student health plans. The third party administrator would then work with an insurance company to arrange contraceptive coverage at no cost through individual policies.

Third party administrators and insurers would collaborate to ensure seamless enrollment. The proposed rules outline how both the third-party administrator and the insurer would be covered without charge to the religious organization or enrollees.

The proposed rules also simplify and clarify what constitutes a “religious employer” in order to exempt contraceptive coverage from their requirements. These employers, which include houses of worship and other religious organizations, may exclude contraception coverage from their employees’ health plans.
Below are details about these policies.

Exemption for Religious Employers

If religious employers have group health plans, they are exempt from the requirement to provide contraceptive coverage.
The NPRM would simplify existing definitions of “religious employers” in relation to contraceptive coverage.
The NPRM would remove the requirement that a religious employer be listed:
1. Its purpose is to inculcate religious values;
2. Only employ people who are religiously aligned with it;
3. To serve only those who agree with its religious principles.

For the purposes of exemption, the simple definition of “religious employers” would be based on a section in the Internal Revenue Code. It would include churches, other places of worship and their affiliated organizations as per Section 6033(a.(3)(A)(iii).

The proposed amendment clarifies that a house or worship is not exempt from the exemption if it provides charitable social service to people of different faiths or employs people of different faiths. According to the Departments, this proposal would not increase the number of employer plans that could be eligible for the exemption beyond what was stated in the 2012 final rules.

Non Profit Religious Organizations: Creating Accommodations
The Advance NPRM also proposes accommodation for non-profit religious organizations. In addition, enrollees will be provided contraceptive coverage without co-pays. A qualified organization is one that meets the following criteria:
1. Opposes the provision of coverage for contraceptive services that are required to be covered under Section 271 of the PHS Act because of religious objections.
2. is a non-profit entity that is organized.
3. identifies itself as a religious organisation;
4. It self-certifies it meets these criteria, and specifies contraceptive services it does not want to provide coverage for.