Employers provide health coverage to
their employees through employer-purchased plans and through self-insured
plans. In self-insured plans
(also called self-funded), the employer assumes direct financial
responsibility for their employees’ medical claims. Covered
workers are divided almost evenly between these two types of
coverage.
Surveys of insurers and employers provide information on the state
of contraceptive coverage.
The Alan Guttmacher Institute – 2002 Survey of Insurers
A 2002 survey of insurers providing employer-purchased insurance found that
86% of plans covered the five leading reversible prescription methods (diaphragm fitting,
one and three-month injectables,
the IUD, and oral
contraceptives).19
The survey also found that health plans designed for states mandating
coverage of contraception were more likely to cover the five leading
methods (87 to 92% depending on whether the plan was an HMO, PPO
or POS) than plans designed for states without mandates (47-61%).
PPO plans designed for states without mandates offered the least
amount of coverage, with fewer than half covering the five leading
methods and 12% covering none. (For more on
state laws click here.)
Kaiser Family Foundation-Health Research and Educational Trust – 2003
and 2004 Surveys of Employers
The 2004 Kaiser-HRET surveyed 1,925 private and public employers, who use a
mix of self-insured and employer-purchased plans. The survey found that 89%
of workers have coverage for oral contraception.20 In
2003, their survey of 2,365 employers found that 83% of small firms (2 to 199
employees) covered oral contraception as opposed to 90% for large firms (200
and up), and 72% of both large and small firms covered all five reversible
methods.
Federal Government Coverage for Contraception
In 1998, Congress passed legislation requiring health plans participating in
the Federal Employees Health Benefit Program (FEHBP) to provide coverage
of all FDA-approved prescription contraceptive methods, devices and services
if other prescription drugs are covered. This coverage did not increase the
government’s premium cost according to a letter from Janice R. Lachance,
Director of the Office of Personnel Management in 2001.21 |
