['Employee Benefits']
["Women's Health Rights and Cancer Act"]
06/10/2024
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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:
- Plans must provide minimum mammography examination coverage, including, but not limited to baseline mammogram for women 35-39 years old, mammograms every two years for women 40-49 years old, annual mammograms for women 50 years and older — more frequently if recommended by physician. (§514C.4)
- Iowa law mirrors the federal Newborns’ and Mothers’ Health Protection Act of 1996, providing for a 48-hour hospital stay for normal deliveries and a 96-hour stay for cesarean deliveries. (§514C.12)
- If a plan is terminated, it must continue to provide coverage to a participant in the second or third trimester of pregnancy. (§514C.14)
- Plans must provide for prescription contraceptive drugs or devices. (§514C.19)
State
Contact
Regulations
Iowa Code; Chapter 514c Special Health and Accident Insurance Coverages:
§514c.4 (Mammograms)
§514c.12 (Post Delivery Benefits)
§514c.14 (Continuation of Care - Pregnancy)
§514c.19 (Contraceptive Drugs/Services)
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)
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