Women's Health Rights and Cancer Act - Hawaii

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)

The state laws include the following provisions:

Hawaii laws provide for coverage for screening by low-dose mammography for occult breast cancer for annual mammograms for women 40 years old and older, and mammograms according to the woman’s physician for women of any age with a history of breast cancer or whose mother or sister has had a history of breast cancer.

For policies that provide pregnancy-related benefits, coverage must include — in addition to any other benefits for treating infertility — a one-time only benefit for all outpatient expenses arising from in vitro fertilization.

For policies that provide for prescription drugs, coverage must include prescription contraceptive services and supplies (with an exemption for religious employers).

State

Contact

Department of Commerce and Consumer Affairs, Division of Insurance

Regulations

Hawaii Revised Statutes, Article 10A

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)