California Contraception Insurance Coverage Refusal Clause

California Health & Safety Code section 1367.25 and California Insurance Code section 10123.196 allow religious employers to require that their plans exclude coverage for contraception.

The law, enacted in 1999, narrowly defines religious employer to mean:

• The inculcation of religious values is the purpose of the entity;
• The entity primarily employs persons who share the religious tenets of the entity;
• The entity serves primarily persons who share the religious tenets of the entity; and
• The entity is a nonprofit organization.

Any religious employer that invokes this exemption must provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons.

Religious employers that invoke this exemption may not do so to exclude coverage for reasons other than contraceptive purposes, such as decreasing the risk of ovarian cancer or eliminating symptoms of menopause, or for contraception that is necessary to preserve the life or health of an enrollee.

 

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