17:48F-13.2 Prepaid prescription service organization, coverage for prescription female contraceptives.
9. A prepaid prescription service organization that provides benefits for expenses incurred in the purchase of outpatient prescription drugs under a contract shall provide coverage under every such contract delivered, issued, executed or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, for expenses incurred in the purchase of prescription female contraceptiveS.For the purposes of this section, “prescription female contraceptives” means any drug or device used for contraception by a female, which is approved by the federal Food and Drug Administration for that purpose, that can only be purchased in this State with a prescription written by a health care professional licensed or authorized to write prescriptions, and includes, but is not limited to, birth control pills and diaphragmS.The coverage provided shall include prescriptions for dispensing contraceptives for:
a. a three-month period for the first dispensing of the contraceptive; and
b. a six-month period for any subsequent dispensing of the same contraceptive, regardless of whether coverage under the contract was in effect at the time of the first dispensing, except that an entity subject to this section may provide coverage for a supply of contraceptives that is for less than a six-month period, if a six-month period would extend beyond the term of the contract.
A religious employer may request, and a prepaid prescription service organization shall grant, an exclusion under the contract for the coverage required by this section if the required coverage conflicts with the religious employer’s bona fide religious beliefs and practiceS.A religious employer that obtains such an exclusion shall provide written notice thereof to prospective enrollees and enrolleeS.The provisions of this section shall not be construed as authorizing a prepaid prescription service organization to exclude coverage for prescription drugs that are prescribed for reasons other than contraceptive purposes or for prescription female contraceptives that are necessary to preserve the life or health of an enrollee. For the purposes of this section, “religious employer” means an employer that is a church, convention or association of churches or an elementary or secondary school that is controlled, operated or principally supported by a church or by a convention or association of churches as defined in 26 U.S.C. S.3121(w)(3)(A), and that qualifies as a tax-exempt organization under 26 U.S.C. S.501(c)(3).
The benefits shall be provided to the same extent as for any other outpatient prescription drug under the contract.
This section shall apply to those prepaid prescription contracts in which the prepaid prescription service organization has reserved the right to change the premium.
L.2005, C. 251, S.9; amended 2017, C. 241, S.9.
Original Text maintained by the State of New Jersey:
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