REPORT TITLE:
Contraceptive Services


DESCRIPTION:
Requires all health insurers, mutual benefit societies, and
health maintenance organizations to cease excluding contraceptive
services and supplies from coverage by repealing the provision of
such coverage as an employer option; exempts certain employers
from providing coverage for contraceptive health care services
that are contrary to the employer's religious tenets. (SD2)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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THE SENATE                              S.B. NO.           S.D. 2
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO HEALTH INSURANCE.



BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1      SECTION 1.  Section 431:10A-116.6, Hawaii Revised Statutes,
 
 2 is amended to read as follows:
 
 3      "[[]§431:10A-116.6[]]  Contraceptive services; options.(a)
 
 4 Notwithstanding any provision of law to the contrary, each
 
 5 employer group health policy, contract, plan, or agreement issued
 
 6 or renewed in this State on or after January 1, [1994,] 2000,
 
 7 that provides for payment of or reimbursement for pregnancy-
 
 8 related services, shall [provide as an employer option,] cease to
 
 9 exclude contraceptive services or supplies for the subscriber or
 
10 any dependent of the subscriber who is covered by the policy.
 
11      (b)  Any policies, contracts, plans, or agreements under
 
12 subsection (a) [above], that provide contraceptive services or
 
13 supplies, or prescription drug coverage, shall not exclude any
 
14 Food and Drug Administration-approved prescriptive contraceptive
 
15 drug or device, or impose any unusual copayment, charge, or
 
16 waiting requirement for such drug or device.
 
17      (c)  For [the purpose] purposes of this section[,
 
18 "contraceptive services"]:
 
19      "Contraceptive services" means physician-delivered,
 
20 physician-supervised, physician assistant-delivered, nurse
 

 
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 1 practitioner-delivered, certified nurse midwife-delivered, or
 
 2 nurse-delivered medical services intended to promote the
 
 3 effective use of prescription contraceptive supplies or devices
 
 4 to prevent unwanted pregnancy.
 
 5      "Contraceptive supplies" means all Food and Drug
 
 6 Administration-approved contraceptive drug or device used to
 
 7 prevent unwanted pregnancy.
 
 8      (d)  Nothing in this section shall be construed to extend
 
 9 the practice or privileges of any health care provider beyond
 
10 that provided in the laws governing the provider's practice and
 
11 privileges."
 
12      SECTION 2.  Section 432:1-604.5, Hawaii Revised Statutes, is
 
13 amended to read as follows:
 
14      "[[]§432:1-604.5[]]  Contraceptive services; options.(a)
 
15 Notwithstanding any provision of law to the contrary, each
 
16 employer group health policy, contract, plan, or agreement issued
 
17 or renewed in this State on or after January 1, [1994,] 2000,
 
18 that provides for payment of or reimbursement for pregnancy-
 
19 related services, shall [provide as an employer option,] cease to
 
20 exclude contraceptive services and contraceptive prescription
 
21 drug coverage or supplies for the subscriber or any dependent of
 
22 the subscriber who is covered by the policy.
 
23      (b)  Any policies, contracts, plans, or agreements under
 

 
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                                     S.B. NO.           S.D. 2
                                                        
                                                        

 
 1 subsection (a), that provide contraceptive services or supplies,
 
 2 or prescription drug coverage, shall not exclude any [Federal]
 
 3 Food and Drug Administration-approved prescriptive contraceptive
 
 4 drug or device, or impose any unusual copayment, charge, or
 
 5 waiting requirement for such drug or device.
 
 6      (c)  For [the purpose] purposes of this section[,
 
 7 "contraceptive services"]:
 
 8      "Contraceptive services" means physician-delivered,
 
 9 physician-supervised, physician assistant-delivered, nurse
 
10 practitioner-delivered, certified nurse midwife-delivered, or
 
11 nurse-delivered medical services intended to promote the
 
12 effective use of prescription contraceptive supplies or devices
 
13 to prevent unwanted pregnancy.
 
14      "Contraceptive supplies" means all Food and Drug
 
15 Administration-approved contraceptive drug or device used to
 
16 prevent unwanted pregnancy.
 
17      (d)  Nothing in this section shall be construed to extend
 
18 the practice or privileges of any health care provider beyond
 
19 that provided in the laws governing the provider's practice and
 
20 privileges."
 
21      SECTION 3.  Chapter 431:10A, Hawaii Revised Statutes, is
 
22 amended by adding a new section to be appropriately designated
 
23 and to read as follows:
 

 
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                                     S.B. NO.           S.D. 2
                                                        
                                                        

 
 1      "§431:10A-     Contraceptive services; religious employers
 
 2 exemption.  (a)  A "religious employer" is an entity for which
 
 3 each of the following is true:
 
 4      (1)  The inculcation of religious values is the primary
 
 5           purpose of the entity; 
 
 6      (2)  The entity primarily employs persons who share the
 
 7           religious tenets of the entity; 
 
 8      (3)  The entity receives no public funding and is not
 
 9           staffed by public employees; and 
 
10      (4)  The entity is a non-profit organization as defined
 
11           under section 501(c)(3) of the Internal Revenue Code of
 
12           1986, as amended.
 
13      (b)  Notwithstanding any other provision of this chapter,
 
14 any religious employer may request a health insurance plan that
 
15 excludes coverage for contraceptive health care services that are
 
16 contrary to the religious employer's religious tenets.  If so
 
17 requested, the health insurer, mutual benefit society, or health
 
18 maintenance organization shall provide a health insurance plan
 
19 that excludes coverage for contraceptive health care services.
 
20 This subsection shall not be construed to deny an enrollee
 
21 coverage of, and timely access to, prescription contraceptive
 
22 drugs and devices and outpatient contraceptive services.
 
23      (c)  Each religious employer that invokes the exemption
 
24 provided under this section shall:
 

 
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                                     S.B. NO.           S.D. 2
                                                        
                                                        

 
 1      (1)  Provide written notice to enrollees upon enrollment
 
 2           with the plan, listing the contraceptive health care
 
 3           services they refuse to cover for reason of conscience
 
 4           or religion;
 
 5      (2)  Provide written information describing how an enrollee
 
 6           may directly access prescription contraceptive drugs
 
 7           and devices and outpatient contraceptive health care
 
 8           services in an expeditious manner; and 
 
 9      (3)  Ensure that enrollees refused services under this
 
10           section have prompt access to the information developed
 
11           under paragraph (2).  Such notice shall appear, in not
 
12           less than twelve point type, in the policy,
 
13           application, and sales brochure for such policy.
 
14      (d)  Nothing in this section shall be construed as
 
15 authorizing an individual health insurance policy to exclude
 
16 coverage for prescription contraceptive drugs or devices ordered
 
17 by a health care provider with prescriptive authority for reasons
 
18 other than contraceptive purposes, or for prescription
 
19 contraception that is necessary to preserve the life or health of
 
20 an enrollee, such as decreasing the risk of ovarian cancer or
 
21 eliminating symptoms of menopause.
 
22      (e)  Health insurers, mutual benefit societies, and health
 
23 maintenance organizations shall allow enrollees in a health plan
 

 
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 1 exempted under this section to directly purchase coverage of
 
 2 prescription contraceptive drugs and devices and outpatient
 
 3 contraceptive services from the health insurer.  The enrollee's
 
 4 cost of purchasing such coverage shall not exceed the enrollee's
 
 5 pro rata share of the price the group purchaser would have paid
 
 6 for such coverage had the group plan not invoked a religious
 
 7 exemption. 
 
 8      (f)  This section shall not be construed as to require a
 
 9 health insurer, mutual benefit society, health maintenance
 
10 organization, health care facility, or health care provider to
 
11 provide any health care services without appropriate payment of
 
12 premium or fee."
 
13      SECTION 4.  Statutory material to be repealed is bracketed.
 
14 New statutory material is underscored.
 
15      SECTION 5.  This Act shall take effect upon its approval.