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Home Employers Industry Insights Informed on ReformPreventive Care Services

Preventive Care Services

Almost all group health plans must cover in-network preventive services and immunizations without cost sharing (e.g., deductibles, coinsurance and copayments) or annual limits.

Preventive care services and immunizations include:

  • Recommended evidence-based preventive services from the United States Preventive Services Task Force with a rating of A or B
  • Immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention
  • Preventive care guidelines developed by the Health Resources and Services Administration and the American Academy of Pediatrics
  • Women’s preventive services, including well-woman visits, support for breastfeeding equipment, contraception and domestic violence screening (certain group health plan sponsors may be exempt from covering contraceptive services, see below)

Contraceptive coverage exemption rules:

Rules finalized under the ACA offer accommodation for eligible organizations that object to covering contraceptive services. Only religious employers – churches or houses of worship as defined by the Internal Revenue Code – can qualify for the exemption. Under the ACA rules, other eligible employers who objected to covering contraceptives on religious grounds were required to self-certify with their insurance carrier or third-party administrator (TPA) or file a notice with the Department of Health and Human Services (HHS). This process placed the responsibility of covering contraceptive services on the insurance carrier or TPA, and ensured the customer/individual policy holder had no cost share expenses for such services.

Final rules issued on Nov. 7, 2018 by multiple federal agencies were set to expand the exemption for employers to not cover contraceptive services under their sponsored group health plans for both religious and moral objections. On Jan. 14, 2019, a Pennsylvania federal court issued a preliminary injunction that prevents the rules from being implemented in any state unless or until the injunction is removed. The injunction maintains the status quo and rules in place under the ACA.

If you are a Cigna HealthcareSM customer and have questions about Preventive Services covered under your plan, please check your plan coverage on or call the customer service number on the back of your ID card.

Related Links

Informed on Reform FAQs No Cost Preventive Medications by Drug Category Guide [PDF]

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Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT); (ii) Life Insurance Company of North America (“LINA”) (Philadelphia, PA); or (iii) New York Life Group Insurance Company of NY (“NYLGICNY”) (New York, NY), formerly known as Cigna Life Insurance Company of New York. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna.

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