State laws cannot regulate self-insured employers, which cover about 60% of insured workers nationwide.) In addition, the federal guarantee specifically requires coverage for 18 methods of contraception used by women (including female sterilization), along with related counseling and services, and it requires this coverage to be provided without any out-of-pocket costs to the patient, such as copayments or deductibles.The federal guarantee does not require similar coverage for vasectomy or male condoms.One regulation allows any employer—nonprofit or for-profit—to exclude some or all contraceptive methods and services from the health plans it sponsors if the employer has religious objections.Another regulation allows employers with moral objections to do the same, although it applies to a slightly narrower set of employers (any employer that is not a publicly traded company).Enforcement of these regulations has been blocked by the courts.Previous federal regulations are in effect that offer an exemption for a much narrower set of explicitly religious employers and provide an “accommodation” for other nonprofit and closely held for-profit employers with religious objections that allows them to avoid paying or arranging for contraceptive coverage while still ensuring that employees and dependents receive coverage seamlessly from the same insurance company.Since the mid-1990s, 28 states have required health insurance plans regulated by the state that provide coverage of prescription drugs and devices to also cover prescription contraceptives.
(An employer that self-insures shoulders the financial risks for health care costs for its employees.
* Religious insurers are not exempt from the mandate but may provide contraceptive coverage through a subcontract with another insurer or third-party entity.
† Enrollees have the option of obtaining coverage directly from insurer.
** Health plans are required to offer employers the option of including coverage for contraception.
€ The state’s law allows pharmacists to dispense the full amount of a prescription at one time, including contraception, but there is no requirement that health insurance plans cover the cost of accessing a year’s worth of contraceptives at one time.