Businesses Urged to Review Abortion Coverage with Roe in Balance

Many employers are reviewing their abortion coverage policies as the U.S. Supreme Court prepares a ruling that could overturn Roe v. Wade.

Regardless of their stance on whether to cover abortion, companies are being advised by their legal counsel to review their policies and, at the very least, make sure they are clear about what they cover. Legal advisers also say companies must be prepared to communicate their positions to employees and answer questions about them.

Companies represented by the Groom Law Group are asking “do we have some exposure, do we have some liability, what should we do? if the 1973 ruling that legalized abortion nationwide is overturned, Christine Keller, the managing partner, said in an interview.

In addition to health insurers, Groom works with hundreds of major employer-sponsored health plans that are self-insured, meaning they pay their employees’ claims directly and are regulated by federal workplace safety law. Employee Retirement Income (ERISA), not by the states. States do, however, have the authority to regulate fully insured health plans that operate within their jurisdiction.

Whether deer Overturned, 26 States Likely to Restrict Abortion, 2021 Report Says analysis by the Guttmacher Institute, a research and policy organization that focuses on reproductive health and rights. Many health plans have been silent about whether they pay for abortion services, while some are explicit about abortion coverage but do not include conditions based on the legality of the procedure by the ‘state, Keller said.

Groom’s recommendation is that “plans put in place, with some precision, what they’re paying for,” along with specific information about what they’re not, Keller said.

In states that restrict abortion, plans that cover the service could be shielded from liability by adding language that says they will provide coverage where abortions are legal, she said. If the company chooses to do so, language could be added indicating that in states where abortions are not legal, travel costs would be covered, she said.

“States have the ability and authority to regulate providers, health care providers, in their state, and providers’ scope of practice,” Keller said. Services in a particular state may no longer be available to plan participants, but self-insured plans can’t change that, she said.

pay to travel

However, if a state attempted to prevent a self-insured plan from paying for travel to another state for abortion services, ERISA would likely override that state law, Keller said. Such a state law would go beyond regulating health care providers, she said.

“But if it’s not written in the plan, then it becomes a lot harder to say there’s a conflict between state law that says you can’t pay for it, and that plan, which actually has no provision on payment for it,” she said.

If abortion-related travel coverage is considered “a significant benefit in the nature of medical care,” participants in high-deductible health plans should meet their annual deductibles of at least $1,400 for individuals and $2,800 for families before the plan can pay for abortion-related travel, Keller said.

Companies should make this clear to registrants, she said. Violating high-deductible requirements would result in enrollees being ineligible to contribute to tax-advantaged health savings accounts used to pay for medical expenses, she said.

Plan terms can change during a plan year, Keller said. Additional benefits must be disclosed to plan members within 210 days of the end of a plan’s year, while reductions in covered health services must be disclosed within 60 days of the change being enacted, it said. she declared.

Most employers cover abortion

Most employers cover abortion, but they don’t always cover elective abortions, Shelley Alpern, director of corporate engagement for Rhia Ventures, said in an interview. Rhia Ventures is a non-profit organization that invests in reproductive health care and files shareholder resolutions related to abortion policies. He follows the audience advertisement by companies on their abortion policies.

Kaiser Family Foundation Employer Health Benefits 2019 Investigation found that only 3% of companies that offer health benefits exclude abortion coverage in at least some circumstances.

“Companies really started paying attention to abortion-related travel after Texas implemented SB 8 in September, and then there’s been this other wave since the SCOTUS leak of more companies saying that they would pay for abortion-related travel,” Alpern says. Texas law allows for the prosecution of anyone who performs or “encourages” an abortion.

Some companies are quick to update their abortion coverage.

“Our reproductive rights benefits are currently administered outside of our health care benefits, as we move faster than our health care administrator to provide our team with the support they need,” said Kim Nguyen, vice -president of human operations for Alloy Financial Services, in an email. Alloy is a software company that helps financial services companies prevent fraud. The company would not disclose its healthcare administrator.

Alloy released a statement on her blog in January announcing new policies to support abortion coverage, including legal and travel expense coverage, and up to $1,500 in out-of-pocket medical expenses for out-of-network abortion care.

Off-grid coverage

If a company pays for its employees to travel to other states for abortions where there are no in-network providers, the company may consider expanding its networks, said Katy Johnson, senior attorney for health policy at the American Benefits Council.

ABC’s membership includes more than 220 major companies that sponsor or administer health and retirement benefits.

Employers are also considering issues with medical travel benefits for employees not enrolled in employer-sponsored health plans, Johnson said. Employers need to think about this carefully because it could mean the company was creating a new health plan and the company would have to make sure the program complied with applicable regulations, she said.

Employers have also started asking whether their current plan covers abortion-related drug benefits and whether they want to expand those benefits, Johnson said.

Stay out of the limelight

Employers are also thinking about how to communicate their policies to employees and how they make broader decisions about what benefits they want to offer, Johnson said.

“Many employers will be pressured by their employees to take a policy stance independent of necessary benefits,” said Roberta Casper Watson, head of the Wagner Law Group’s health and wellness group.

Many companies probably want to stay out of the spotlight on the issue, Watson said in an interview.

“There are going to be some interesting test cases, and some employers just won’t want to be in the middle of a test case,” Watson said. “I’ve never had a client who looked forward to being a test for anything before.”

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