20-2329. Prescription contraceptive drugs and devices; definition

A. An accountable health plan that provides a health benefits plan that provides coverage for:

1. Prescription drugs shall also provide coverage for any prescribed drug or device that is approved by the United States food and drug administration for use as a contraceptive. An accountable health plan may use a drug formulary, multitiered drug formulary or list but that formulary or list shall include oral, implant and injectable contraceptive drugs, intrauterine devices and prescription barrier methods if the accountable health plan does not impose deductibles, coinsurance, copayments or other cost containment measures for contraceptive drugs that are greater than the deductibles, coinsurance, copayments or other cost containment measures for other drugs on the same level of the formulary or list.

2. Outpatient health care services shall also provide coverage for outpatient contraceptive services. For the purposes of this paragraph, "outpatient contraceptive services" means consultations, examinations, procedures and medical services provided on an outpatient basis and related to the use of United States food and drug prescription contraceptive methods to prevent unintended pregnancies.

B. Notwithstanding subsection A, a religious employer whose religious tenets prohibit the use of prescribed contraceptive methods may require that the accountable health plan provide a health benefits plan without coverage for all federal food and drug administration approved contraceptive methods. A religious employer shall submit a written affidavit to the accountable health plan stating that it is a religious employer. On receipt of the affidavit, the accountable health plan shall issue to the religious employer a health benefits plan that excludes coverage of prescription contraceptive methods. The accountable health plan shall retain the affidavit for the duration of the health benefits plan and any renewals of the plan.

C. Before enrollment in the plan, every religious employer that invokes this exemption shall provide prospective enrollees written notice that the religious employer refuses to cover all federal food and drug administration approved contraceptive methods for religious reasons.

D. Subsection B shall not exclude coverage for prescription contraceptive methods ordered by a health care provider with prescriptive authority for medical indications other than to prevent an unintended pregnancy. An accountable health plan may require the enrollee to first pay for the prescription and then submit a claim to the accountable health plan along with evidence that the prescription is for a noncontraceptive purpose. An accountable health plan may charge an administrative fee for handling claims under this subsection.

E. A religious employer shall not discriminate against an employee who independently chooses to obtain insurance coverage or prescriptions for contraceptives from another source.

F. For the purposes of this section, "religious employer" means an entity for which all of the following apply:

1. The entity primarily employs persons who share the religious tenets of the entity.

2. The entity serves primarily persons who share the religious tenets of the entity.

3. The entity is a nonprofit organization as described in section 6033(a)(2)(A)i or iii of the internal revenue code of 1986, as amended.

20-2329. Prescription contraceptive drugs and devices; definition

A. An accountable health plan that provides a health benefits plan that provides coverage for:

1. Prescription drugs shall also provide coverage for any prescribed drug or device that is approved by the United States food and drug administration for use as a contraceptive. An accountable health plan may use a drug formulary, multitiered drug formulary or list but that formulary or list shall include oral, implant and injectable contraceptive drugs, intrauterine devices and prescription barrier methods if the accountable health plan does not impose deductibles, coinsurance, copayments or other cost containment measures for contraceptive drugs that are greater than the deductibles, coinsurance, copayments or other cost containment measures for other drugs on the same level of the formulary or list.

2. Outpatient health care services shall also provide coverage for outpatient contraceptive services. For the purposes of this paragraph, "outpatient contraceptive services" means consultations, examinations, procedures and medical services provided on an outpatient basis and related to the use of United States food and drug prescription contraceptive methods to prevent unintended pregnancies.

B. Notwithstanding subsection A, a religious employer whose religious tenets prohibit the use of prescribed contraceptive methods may require that the accountable health plan provide a health benefits plan without coverage for all federal food and drug administration approved contraceptive methods. A religious employer shall submit a written affidavit to the accountable health plan stating that it is a religious employer. On receipt of the affidavit, the accountable health plan shall issue to the religious employer a health benefits plan that excludes coverage of prescription contraceptive methods. The accountable health plan shall retain the affidavit for the duration of the health benefits plan and any renewals of the plan.

C. Before enrollment in the plan, every religious employer that invokes this exemption shall provide prospective enrollees written notice that the religious employer refuses to cover all federal food and drug administration approved contraceptive methods for religious reasons.

D. Subsection B shall not exclude coverage for prescription contraceptive methods ordered by a health care provider with prescriptive authority for medical indications other than to prevent an unintended pregnancy. An accountable health plan may require the enrollee to first pay for the prescription and then submit a claim to the accountable health plan along with evidence that the prescription is for a noncontraceptive purpose. An accountable health plan may charge an administrative fee for handling claims under this subsection.

E. A religious employer shall not discriminate against an employee who independently chooses to obtain insurance coverage or prescriptions for contraceptives from another source.

F. For the purposes of this section, "religious employer" means an entity for which all of the following apply:

1. The entity primarily employs persons who share the religious tenets of the entity.

2. The entity serves primarily persons who share the religious tenets of the entity.

3. The entity is a nonprofit organization as described in section 6033(a)(2)(A)i or iii of the internal revenue code of 1986, as amended.