Women's Health Rights and Cancer Act - Wyoming

Summary of differences between federal and state regulations

Employee health plans are generally covered under the federal jurisdiction of the Employee Retirement Income Security Act (ERISA). Laws for women specifically include the Women’s Health and Cancer Rights Act of 1998, and Newborns’ and Mothers’ Health Protection Act of 1996. State insurance laws, however, do apply. The federal laws regarding women’s health rights include the following provisions:

• If the plan covers mastectomies, it must cover all stages of reconstruction of the breast on which the mastectomy has been performed; surgery and reconstruction of the other breast to produce a symmetrical appearance; and prostheses and physical complications of mastectomy, including lymphedemas in a manner determined in consultation with the attending physician and the patient. (Women’s Health Rights and Cancer Act)
• If the group health plan provides maternity coverage, it must cover at least a 48-hour hospital stay following childbirth (96-hour stay in the case of Cesarean section). (Newborns' and Mothers' Health Protection Act)

Under state law, the plan must cover a pelvic examination and Pap smear for any nonsymptomatic women and a breast cancer examination including a screening mammogram and clinical breast examination for any nonsymptomatic participant. This coverage is to be provided with no deductible due and payable. A health plan must, at a minimum, be liable for eighty percent (80 percent) of the reimbursement allowance of the health plan up to a maximum of $250.00. (§26-19-107)

State

Contact

Wyoming Insurance Department

Regulations

Wyoming Statutes; Title 26 Insurance Code
Chapter 19 Group and Blanket Disability Insurance
www.lexisnexis.com/hottopics/wystatutes/

Federal

Contact

Employee Benefits Security Administration (EBSA)

Regulations

See the text of the Women’s Health and Cancer Rights Act under Acts/Laws, Title 1, Subtitle B, Part 7, Subpart B; and the U.S. Code, Title 29, chapter 18, §1185b.

See also U. S. Code Title 29, chapter 18, §1185 for laws regarding mothers.

29 CFR 1604.10 (Employment policies relating to pregnancy and childbirth)

29 CFR chapter XXV (Parts 2509 – 2590)