CurrentAetnaPolicy N/A

Optional elective abortion coverage rider notification and opt-out process

Governs notification and opt-out procedures for elective abortion coverage for Missouri residents and instructs employers/plan sponsors on how to exclude the benefit for enrollees based on moral, ethical, or religious beliefs.

Policy Summary

PayerAetna

PolicyOptional elective abortion coverage rider notification and opt-out process

Policy CodePolicy N/A

Change TypeNo material changes

Effective Date

Next Review Date

Key ActionPlan administrators or brokers must provide a list of members who elect to exclude elective abortion coverage at enrollment to the Sales or Account Management Representative.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Missouriapplicable state

1optional rider referenced

opt-outopt-out right

Sales/Acct Mgmtcontact for questions

Elective Abortion Rider Coverage & Opt-Out Rules

Elective abortion rider coverage and opt-out criteria

Coverage and opt-out rules for the optional elective abortion rider pursuant to Missouri law.

Missouri law requires notification regarding whether an optional rider for elective abortion coverage has been purchased.

Plan status

The planholder has not purchased the optional elective abortion rider pursuant to VAMS section 376.805.
The plan may nonetheless include elective abortion coverage due to state law or plan sponsor benefit elections; verify plan benefits with Sales or Account Management Representative.

An enrollee in a group health plan that includes coverage for elective abortions may elect to exclude (opt out of) that coverage and not pay for it if it is contrary to his or her moral, ethical, or religious beliefs.

Policy Summary

PayerAetna

PolicyOptional elective abortion coverage rider notification and opt-out process

Policy CodePolicy N/A

Change TypeNo material changes

Effective Date

Next Review Date

Key ActionPlan administrators or brokers must provide a list of members who elect to exclude elective abortion coverage at enrollment to the Sales or Account Management Representative.

SourceLink

On This Page

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Required Actions for Plan Administrators, Brokers, and Sales

Documentation Required

Opt-out submission process

Plan administrators or brokers must provide Sales or Account Management with a list of members who elect to exclude the elective abortion benefit at the time of enrollment.

Provide the list at time of enrollment to Sales or Account Management Representative.

Prior Authorization

Coverage verification

If it is unclear whether a specific plan includes elective abortion coverage, contact your Sales or Account Management Representative to confirm the plan sponsor’s benefit elections.

Plans may still include elective abortion coverage due to state law or plan sponsor elections; verify with Sales/Account Management.

Key Terms

inv-04: Optional elective abortion coverage rider

DefinitionOptional elective abortion coverage rider — an add-on to a health plan that provides coverage for elective abortions; notification of purchase is required under Missouri law (VAMS section 376.805).

Purchase implicationIf the optional rider has not been purchased, the planholder does not have elective abortion coverage under that rider.

Plan-level implicationEven if the optional rider is not purchased, the plan may still include elective abortion coverage due to state law or plan sponsor benefit elections — verify plan details.

Notification requirementMissouri law requires notification about whether the optional rider has been purchased.

inv-05: Opt-out

DefinitionOpt-out — the enrollee's right to exclude and not pay for elective abortion coverage if it is contrary to their moral, ethical, or religious beliefs.

Who may opt outAn enrollee who is a member of a group health plan that includes coverage for elective abortions may elect to exclude that coverage.

Effect of opting outThe enrollee will not have the elective abortion benefit and will not pay for that coverage.

Verification and questionsIf unclear whether a plan includes elective abortion coverage, contact your Sales or Account Management Representative for plan sponsor benefit elections.