Introducing the Eligible Organization Designation
The final rules replace the TESH with a new exception for Eligible Organizations. An Eligible Organization is a non-profit religious organization with religious objections to covering contraceptive services. Those organizations that self-certify as an Eligible Organization may exclude coverage for some or all contraceptive services. The new Eligible Organization designation is effective for plan years starting on or after Jan. 1, 2014.
A new self-certification form from the Department of Labor must be completed by employers claiming the Eligible Organization exception for plan years beginning on or after Jan. 1, 2014: EBSA Form 700 – Certification for Plan Years beginning on or after 1/1/14.
The Affordable Care Act (ACA) requires non-grandfathered health plans to cover contraceptive services for women without cost-share. However, group health plans sponsored by certain religious employers, and group health insurance coverage provided in connection with such plans, are exempt from the requirement to cover contraceptive services for women.
On June 28, 2013, the Departments of Health and Human Services (HHS), Labor, and the Treasury issued final rules on contraceptive coverage and announced four key changes:
- Modification of the Religious Employer Exemption (REE) definition.
- Extension of the current Temporary Enforcement Safe Harbor (TESH) through Dec. 31, 2013.
- Replacement of the TESH with an Eligible Organization designation for plan years starting on or after Jan. 1, 2014, including a new self-certification form for Eligible Organizations.
- Requires that a health insurance issuer providing fully insured coverage or a third-party administrator that receives certification from an Eligible Organization provide direct payment for contraceptives services at no cost to the plan or its members.
For more information, review the Religious Exemptions to Contraceptive Coverage.