SB 907 — Health insurance; coverage for contraceptives.

SESSION history | hilite | pdf | print version 18104374D18106137D SENATE BILL NO.

907 OfferedAMENDMENT IN THE NATURE OF A SUBSTITUTE (Proposed by the Senate Committee on Commerce and Labor on January 19,29, 20182018) (Patron Prior to Substitute--Senator McClellan) A BILL to amend and reenact § 38.2-3407.5:1 of the Code of Virginia, relating to health insurance;

coverage for prescription contraceptives.

---------- Patron-- McClellan ---------- Referred to Committee on Commerce and Labor ---------- Be it enacted by the General Assembly of Virginia:

That § 38.2-3407.05:138.2-3407.5:1 of the Code of Virginia is amended and reenacted as follows:

"Contraceptive device" means any contraceptive device or non-drug product that has been approved by the FDA.FDA for use by women.

"Contraceptive drug" includes any drug approved by the FDA to prevent an unwanted pregnancy.pregnancy for use by women.

"Contraceptive procedure" means any permanent or semi-permanent procedure that prevents pregnancies in women, including tubal ligation.

"Medical"Religious need"employer" includesmeans considerations such as severity of side effects, difference in permanence and reversibility of a contraceptive drug or device, or an abilityemployer: to adhere to the appropriate use of the item, as determined by the attending health care provider.

1.

Whose purpose is the inculcation of religious values;

2.

That primarily employs persons who share the religious tenets of the employer;

3.

That primarily serves persons who share the religious tenets of the employer;

and 4.

That is a nonprofit organization under § 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code.

and (iii) health maintenance organization providing a health care plan for health care services, whose policy, contract or plan, including any certificate or evidence of coverage issued in connection with such policy, contract or plan, includes coverage for prescription drugs on an outpatient basis, shall offer and make available provide coverage thereunder for any prescribed (a) contraceptive drug oror, (b) contraceptive device approved by the United States Food and Drug Administration for use as a contraceptive.contraceptive, or (c) contraceptive procedure.

No C.

Except as provided in subsection D, no insurer, corporation or health maintenance organization shall impose upon any person receiving prescription contraceptive benefits pursuant to this section any (i) copayment, coinsurance payment or fee that is not equally imposed upon all individuals in the same benefit category, class, coinsurance level or copayment level receiving benefits for prescription drugs, or (ii) reduction in allowable reimbursement for prescription drug benefits.

No insurer, corporation or health maintenance organization shall impose upon any person receiving prescription contraceptive benefits pursuant to this section any (i) copayment, coinsurance payment or fee that is not equally imposed upon all individuals in the same benefit category, class, coinsurance level or copayment level receiving benefits for prescription drugs, or (ii) reduction in allowable reimbursement for prescription drug benefits.

C.

IfAn ainsurer, coveredcorporation, individual'sor health caremaintenance providerorganization recommendssubject ato particularthis contraceptivesection drugshall ornot contraceptiveimpose deviceany approvedburdensome byrestrictions theor FDAdelays foron the individualcoverage basedrequired onby athis determinationsection ofand medicalshall need,provide theclear insurerinformation, shallin deferwriting, toabout the provider'scontraceptive determinationcoverage included and judgmentexcluded andin shallits provideoffered coverageplans, withoutavailable coston sharingits forwebsite and by mail at the prescribedrequest contraceptiveof druga present or contraceptivepotential device.covered individual.

An entity covered by this section shall not impose any burdensome restrictions or delays on the coverage required in this section and shall provide clear information, in writing, about the contraceptive coverage included and excluded in its offered plans, available on its website and by mail at the request of a present or potential covered individual.

G.

or 2.

Require coverage for experimental contraceptive drugs not approved by the United States Food and Drug Administration FDA.FDA;

or 4.

Apply to a grandfathered health benefit plan as defined in § 38.2-3438.

G.

An insurer, corporation, or health maintenance organization subject to this section shall apply the same procedures for requesting an exception for contraceptive drugs not otherwise covered by the contract, policy or plan that the insurer, corporation, or health maintenance organization is required to apply pursuant to 45 C.F.R.

§ 156.122(c) with respect to prescription drugs not otherwise covered by its contract, policy or plan.

I.

Notwithstanding any provision of this section to the contrary, an insurer, corporation, or health maintenance organization may offer to a religious employer a policy, contract, or plan that does not include coverage for contraceptive drugs, contraceptive devices, or contraceptive procedures that are contrary to the religious employer's religious tenets only if the insurer, corporation, or health maintenance organization notifies in writing all employees who may be covered under the policy, contract, or plan of the drugs, contraceptive devices, or contraceptive procedures that the employer refuses to cover for religious reasons.