The bill significantly expands contraceptive coverage under health insurance plans. It requires that, starting January 1, 2025, all individual or group health insurance contracts, plans, or policies issued in the state must cover FDA-approved contraceptive drugs, devices, and products without cost-sharing. This includes voluntary sterilization procedures, related clinical services, and follow-up services. Insurers cannot impose deductibles, coinsurance, copayments, or any other cost-sharing requirements for these services, and they must allow for a supply of up to twelve months of contraception to be dispensed at once. The bill also ensures that coverage benefits are the same for an enrollee's covered spouse or domestic partner and dependents. It includes provisions for religious employers to exclude contraceptive coverage that contradicts their religious tenets, except for non-contraceptive purposes like reducing the risk of ovarian cancer or treating menopause symptoms. The Department is tasked with monitoring compliance, which includes adopting regulations, engaging stakeholders, conducting random reviews, and submitting an annual report on compliance.

The bill also amends existing law to ensure that health insurance issuers reimburse for up to a 365-day supply of prescription contraception, which can be furnished all at once or over the course of twelve months. It prohibits health plans from imposing utilization control or medical management that limits the supply of FDA-approved contraception to less than a twelve-month supply. Furthermore, the bill mandates that every individual or group health insurance contract issued in the state on or after January 1, 2025, shall provide coverage for all FDA-approved contraceptive drugs, devices, and other products, including voluntary sterilization procedures and related clinical services, without cost-sharing requirements. It specifies that coverage should include at least one therapeutic equivalent of an FDA-approved contraceptive if the original is not available or tolerated by the patient, and that over-the-counter contraceptives should be covered without a prescription at in-network pharmacies. The act will take effect upon passage.

Statutes affected:
2088  as amended: 27-18-57, 27-19-48, 27-20-43, 27-41-59
2088: 27-18-57, 27-19-48, 27-20-43, 27-41-59