Supreme Court's Roe v. Wade Decision: Carrier Responses

Dec 28, 2022

Category

The Supreme Court released its decision regarding abortion rights on June 24, essentially reversing the previous Roe v. Wade and Planned Parenthood v. Casey decisions. While this decision does not directly impact how employers may provide or restrict coverage for abortions via their group health plans, the ability for states to now vary their approaches toward abortion coverage as desired may require employers to reconsider how such coverage is provided, if any.

Our carrier partners are reviewing the impact of this decision. More information will be coming soon, so check back for updates!

CARRIER	STATE	RESPONSE
Aetna	CA	The abortion benefit is updated as of October 2022 to provide the following coverage: Non-HSA plans updated to 0%, deductible waived HSA plans updated to 0% after deductible
Aetna	CT, NY	In legal review.
Anthem	CA	Travel and Lodging Benefit rider available at no additional cost. Employer makes election on employer application. Flyer
Anthem	CT, NH, NY	In legal review.
Banner\|Aetna	AZ	In legal review, more to come. At this time, coverage will be available if it complies will state law. If the state prohibits services, those services will not be covered.
Blue Cross Blue Shield of Arizona	AZ	Will cover abortion with prior authorization and if the mother’s life is in danger.
Blue Shield of California	CA	Blue Shield is providing a travel reimbursement program for members living in states that impose restrictions or bans on pregnancy termination services with access to these services in states where they remain legally available. This program will include all fully-insured and self-funded groups, except for: Groups without pregnancy termination benefits (e.g. groups with religious exemption) Groups that elect to opt-out
CaliforniaChoice	n/a	Refer to the enrolled carrier.
Covered California	n/a	Refer to the enrolled carrier.
Cigna	Nationwide	In legal review.
Cigna + Oscar	CA	In legal review.
Cigna + Oscar	CT	In legal review, more to come. At this time coverage is only available for therapeutic abortions; those performed to save the life or health of the mother or in cases of rape or incest.
Cigna Administered by Oscar	AZ	Coverage only for therapeutic abortions. A therapeutic abortion is one performed to save the life of the mother or in cases of rape or incest. For fully-insured ACA plans, covered benefits follow the employer's location and extend to members residing or traveling out of state, even where services can potentially not be accessed.
EmblemHealth	NY	In legal review.
Empire	NY	In legal review.
Health Net	CA	Members will have access to abortion services in states that provide such services.
Healthfirst	NY	In legal review.
HealthPass	NY	Refer to the enrolled carrier.
Humana	AZ	In legal review.
Kaiser Permanente	CA	Kaiser Permanente will cover pregnancy termination services by a qualified provider in a state where access is not restricted or prohibited in accordance with the member’s plan benefits. The National Member Services Contact Center has established a special team with the expertise to answer member questions regarding the member’s specific situation. For members who live outside CA but their employer is based in CA and have opted into the travel and lodging reimbursement program, the members travel and lodging for this service will be covered.
Oscar	NY	In legal review.
Oxford	CT, NY	In legal review, more to come. View the Travel & Lodging FAQ. Fully-Insured: UnitedHealthcare intends to file benefit riders to add travel and lodging benefits to their Certificates of Coverage (COC) to facilitate access to covered health services. If approved, this benefit will cover services under the policy which, because of law or regulation, are not available in the member's resident state. Riders are subject to approval by each state's department of insurance. Self-Funded: Groups may add a travel and lodging benefit to their group health plan. This benefit can be requested to take effect mid-year. See FAQ for details.
UnitedHealthcare	Nationwide	In legal review, more to come. View the Travel & Lodging FAQ. Fully-Insured: UnitedHealthcare intends to file benefit riders to add travel and lodging benefits to their Certificates of Coverage (COC) to facilitate access to covered health services. If approved, this benefit will cover services under the policy which, because of law or regulation, are not available in the member's resident state. Riders are subject to approval by each state's department of insurance. Self-Funded: Groups may add a travel and lodging benefit to their group health plan. This benefit can be requested to take effect mid-year. See FAQ for details.