Microsoft word - 1999hb-05950-r000159-fc.doc

House of Representatives
File No. 159
January Session, 1999
House of Representatives, April 7, 1999 The Committee on Insurance and Real Estate reported throughREP. AMANN of the 118th Dist., Chairperson of theCommittee on the part of the House, that the substitute billought to pass.
An Act Requiring Health Insurers to Cover Prescription Birth
Control.

Be it enacted by the Senate and House of Representatives in GeneralAssembly convened: Section 1. (NEW) (a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general statutes delivered, issued for delivery, renewed or continued in this state on or after October 1, 1999, that provides coverage for outpatient prescription drugs approved by the federal Food and Drug Administration shall not exclude coverage for prescription contraceptive methods approved by the federal Food and Drug Administration.
(b) Notwithstanding any other provision of this section, any insurance company, hospital or medical service corporation, or health care center may issue to a religious employer an individual health insurance policy that excludes coverage for prescription contraceptive sHB5950 / File No. 159
File No. 159
methods which are contrary to the religious employer's bona fide (c) Any health insurance policy issued pursuant to subsection (b) of this section shall provide written notice to each insured or prospective insured that prescription contraceptive methods are excluded from coverage pursuant to said subsection. Such notice shall appear, in not less than ten point type, in the policy, application and sales brochure (d) Nothing in this section shall be construed as authorizing an individual health insurance policy to exclude coverage for prescription drugs ordered by a health care provider with prescriptive authority for reasons other than contraceptive purposes.
(e) Notwithstanding any other provision of this section, any insurance company, hospital or medical service corporation, or health care center which is owned, operated or substantially controlled by a religious organization which has religious or moral tenets which conflict with the requirements of this section may provide for the coverage of prescription contraceptive methods as required under this section through another such entity offering a limited benefit plan. The cost, terms and availability of such coverage shall not differ from the cost, terms and availability of other prescription coverage offered to (f) As used in this section, "religious employer" means an employer that is a "qualified church-controlled organization" as defined in 26 USC 3121 or a church-affiliated organization.
Sec. 2. (NEW) (a) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general statutes delivered, issued for delivery, renewed or continued in this state on or after October 1, 1999, that provides coverage for outpatient prescription drugs approved by the sHB5950 / File No. 159
File No. 159
federal Food and Drug Administration shall not exclude coverage for prescription contraceptive methods approved by the federal Food and (b) Notwithstanding any other provision of this section, any insurance company, hospital or medical service corporation, or health care center may issue to a religious employer a group health insurance policy that excludes coverage for prescription contraceptive methods which are contrary to the religious employer's bona fide religious (c) Any health insurance policy issued pursuant to subsection (b) of this section shall provide written notice to each insured or prospective insured that prescription contraceptive methods are excluded from coverage pursuant to said subsection. Such notice shall appear, in not less than ten point type, in the policy, application and sales brochure (d) Nothing in this section shall be construed as authorizing a group health insurance policy to exclude coverage for prescription drugs ordered by a health care provider with prescriptive authority for reasons other than contraceptive purposes.
(e) Notwithstanding any other provision of this section, any insurance company, hospital or medical service corporation, or health care center which is owned, operated or substantially controlled by a religious organization which has religious or moral tenets which conflict with the requirements of this section may provide for the coverage of prescription contraceptive methods as required under this section through another such entity offering a limited benefit plan. The cost, terms and availability of such coverage shall not differ from the cost, terms and availability of other prescription coverage offered to (f) As used in this section, "religious employer" means an employer sHB5950 / File No. 159
File No. 159
that is a "qualified church-controlled organization" as defined in 26 USC 3121 or a church-affiliated organization.
Committee Vote:
sHB5950 / File No. 159
File No. 159
The following fiscal impact statement and bill analysis are prepared for the benefit of members of the General Assembly, solely for the purpose of information, summarization, and explanation, and do not represent the intent of the General Assembly or either House thereof for any purpose: OFA Fiscal Note
State Impact:
Affected Agencies:
Department of Insurance, State Comptroller Municipal Impact:
Explanation
State Impact:
The bill prohibits individual and group health insurance policies that cover federal Food and Drug Administration (FDA) - approvedprescription drugs on an outpatient basis from excluding FDA -approved prescription contraceptive methods. The bill allows insurersto offer religious employers with bona fide religious tenets againstsuch coverage policies that exclude such drugs.
The bill is not anticipated to have a fiscal impact on the state employee health service accounts. The state employee health insuranceplans provide coverage for prescription contraceptive methods.
The Department of Insurance will review this required coverage in health plans upon renewal after October 1, 1999.
Municipal Impact:
To the extent that prescription contraceptive methods are not sHB5950 / File No. 159
File No. 159
covered by a municipality's employee health insurance policy, theremay be increased municipal costs to provide it. The bill's impact onmunicipal health insurance costs will vary by municipality dependingon the current coverage and cannot be determined at this time.
sHB5950 / File No. 159
File No. 159
OLR Bill Analysis
HB 5950
An Act Requiring Health Insurers to Cover Prescription Birth
Control

SUMMARY: With one exception, this bill prohibits individual and
group health insurance policies that cover federal Food and Drug
Administration (FDA)-approved prescription drugs on an outpatient
basis from excluding FDA-approved prescription contraceptive
methods. The bill allows insurers to offer religious employers with
bona fide religious tenets against such coverage policies that exclude
such drugs.
The bill allows insurers owned, operated, or controlled by religious organizations with religious or moral tenets that conflict with thecoverage requirement to offer prescription contraceptive coveragethrough another company providing limited benefit plans. The cost,terms, and availability of coverage must be equivalent to otherprescription coverage offered by the insurer.
The requirement applies to hospital and medical service plans offered by HMOs and health insurance policies that cover: (1) basichospital expenses, (2) basic medical-surgical expenses, (3) majormedical expenses, and (4) hospital or medical services.
FURTHER EXPLANATION
Religious Employer
The bill specifies that a "religious employer" is a qualified church- controlled organization as defined under the federal Internal RevenueCode or a church-affiliated organization. Policies offered by religiousemployers that exclude contraceptive coverage must give each insuredor prospective insured written notice in the policy, application, and sHB5950 / File No. 159
File No. 159
sales brochure that contraceptive coverage is excluded. The noticemust be in at least 10-point type.
Prescription Drugs for Other Purposes
The bill prohibits anyone from reading its provisions to say that it allows insurers or employers to exclude coverage for prescriptiondrugs prescribed by a doctor for purposes other than contraception.
BACKGROUND
FDA-Approved Contraceptives
The FDA approved five contraceptive methods (Norplant, Depo- Provera, Intrauterine Device (IUD), diaphragm, and contraceptivepill).
COMMITTEE ACTION
sHB5950 / File No. 159

Source: http://search.cga.state.ct.us/ps99/Fc/pdf/1999HB-05950-R000159-FC.pdf

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