Legislatively Speaking
New Guidelines for Preventive Care and
Screenings for Women
On August 1, 2011, the Department of Health and Human Services
(HHS) released newly expanded guidelines for group health plans and
health insurance issuers on coverage for preventive care services
under the federal health care reform law.
These new HHS guidelines focus on women's health issues and
build on last year's announced list of preventive health care
services that must be covered on a first dollar basis. In other
words, these benefits must be covered at 100 percent with no
copayments, no deductibles or other cost sharing.
All nongrandfathered health plans (both insured and self-insured
plans) must include these services (see chart below) beginning on
or after August 1, 2012. Insurance carriers and third party
administrators will include newly-required coverages in their
materials and collectively administer preventive coverage benefits
as defined under federal law. The law does not require new employer
notices about the expanded list of women's preventive care
services. Unlike other changes in the law, these newly expanded
services simply will be reflected in plan summaries.
