Preventive Services and Closely Held Corporations
Federal agencies released final regulations on the preventive services mandate of the Patient Protection and Affordable Care Act (ACA) that requires non-grandfathered group health plans to provide coverage without cost-sharing for specific preventive services, which for women include contraceptive services. The 2015 Final Rules (applicable for plan years beginning on or after September 14, 2015) provide the following:
- Formalizes prior guidance requiring a plan to cover out-of-network services without cost sharing if the plan does not have an in-network provider who can provide a required preventive service.
- Provides for midyear plan changes if a recommended preventive service is downgraded (by task force or advisory body) to a “D” rating or is subject to a safety recall or other significant safety concern.
- Provides contraceptive coverage accommodations for eligible organizations.
Read more about the Final Rules and preventive services coverage.