The National Business Group on Health notes that although most employers cover some type of contraception, it is important for employers to periodically examine the extent of coverage and counseling to ensure that it is appropriate for their covered population.⁶⁴

What types of contraception are currently approved by the FDA?
There are many different types of contraceptive methods approved by the Food and Drug Administration (FDA) for the prevention of pregnancy. (Click here to see PDF File of FDA table) Each type has its own side effect profile, risk, efficacy, and recommended duration of use.

Why is it important to offer more than one type of contraceptive method?
Due to the side effect profile of some medications and devices, the difference in permanence and reversibility of contraceptives, and women’s personal preferences, each health plan should offer the full range of FDA-approved contraceptive methods.

Women may have pre-existing conditions that limit their range of choices while others can have mild to very serious side effects from certain methods. Only a woman and her doctor can decide on the best method of contraception.

Allowing women to select their own method from a range of options also promotes greater usage of contraception. Research shows that the greater satisfaction a woman feels about the physical and psychological effects of a particular method of birth control the more likely she is to use it correctly and consistently.⁶⁵ The correct and consistent use of contraception prevents unintended pregnancy and thus reduces overall health care costs by eliminating unintended pregnancy as a source of medical claims, lost productivity, absenteeism and presenteeism.

How much will adding coverage for contraceptives cost?
Comprehensive contraceptive coverage is not expensive. The average total cost (including administrative costs) of adding coverage of reversible methods of contraception to a health plan that does not currently cover contraceptives is $25.31 per employee per year (adjusted to 2005 dollars). Assuming that employers will cover 80% of this cost, the added cost to employers of providing contraception coverage is just $1.69 per month – a mean increase of less than 1% in employer’s cost of proving medical coverage (Darroch, 1998 with updated cost calculations using the NASA Inflation Calculator).

Contraception is prevention and as the old adage goes “an ounce of prevention is worth a pound of cure.” While the average cost of a one year supply of prescription birth control pills costs $240 to $300, the outcomes of an unintended pregnancy are much higher:

Adjusting your health plan’s formulary to better meet the needs of women
Benefits managers and others can change what medications and devices are covered in their health plans’ formularies. Covering more types of contraceptives can better meet the needs of your employees and reduce your overall costs by preventing unintended pregnancies. The following is a list of questions that you can ask a health plan broker to find out what types of services your health plan offers and how those services can be adjusted to meet the needs of your employees.

• What type of contraceptive methods does our current health plan(s) offer to employees?
   
• What methods of FDA-approved contraception are the most cost effective?
   
• What methods of FDA-approved contraception are most frequently used by our employee population?
   
• If our current health plan(s) offers only one method of contraception, such as oral contraception, how can I go about adding methods of contraception to the formulary?
   
• What co-pays are charged for the different methods of contraception? If there is a difference in co-pays between methods, is this likely to influence a consumer’s decision-making?
   
• Is the language in our plan(s) clear or should we improve our description of covered products to avoid vagueness and misinterpretation?

Actionable Strategies for Employers to Reduce the Number of Unintended Pregnancies Among Their Workforce

• Raise awareness about the variety of safe and effective contraceptive options that are available to women.
  This information could be given to employees during health and wellness programs or during open enrollment (health plan renewal time).
   
• Through worksite health and wellness programs, educate men and women about the health and cost benefits of family planning.
  Develop employee education materials that stress the health and cost benefits of healthy preconception, and planned and safe pregnancies.
   
• Encourage employees to speak with their providers about topics related to family planning.
  Provide employees with a checklist of questions they may want to ask their providers about contraception, preconception, and safe motherhood.
   
• Ensure that information about pregnancy is culturally and linguistically competent.
  Provide materials at the worksite that are racially and ethnically sensitive, and culturally competent. This is particularly important, as culture sometimes has an impact on contraceptive choice and family planning practices.⁷²