Preventive Services Mandate


Purpose:

To require all non-excepted, non-grandfathered health plans to provide coverage for preventive care benefits without any cost-sharing on the part of the covered individual


Intent:

To reduce the overall cost of future health care by providing preventive care coverage at no expense


Related Provision:

Elimination of Annual Limits on Coverage


Health Plans Affected by this Provision:


Year Effective: 2010
Medical Plan: Yes, unless plan is Grandfathered, a plan in effect and without significantly changed coverage or premium share since March 23, 2010
Dental/Vision Plan: No, if stand-alone benefit excepted from HIPAA’s portability provisions
HRA: Yes, unless benefit excepted from HIPAA’s portability provisions or integrated with medical plan
Health Care FSA: Yes, unless benefit excepted from HIPAA’s portability provisions

Document Downloads:


Document Title Last Updated
Preventive Services Mandate Flyer  
ACA Implementation Part XIX FAQs, May 2, 2014 05/02/2014
Non-Excepted Health Care FSA - Flow Charts  
DOL Guidance for Health FSAs and HRAs (2013)  
Treasury Department Guidance (2011)  
Contraceptive Coverage Guidance (2012)  
Location (map)
1350 Deming Way, Ste 300
Middleton, WI 53562-4640

Mail Address
PO Box 44347
Madison, WI 53744-4347