(a) The General Assembly finds and declares that: (1) Maternal and infant health are greatly improved when women
have access to contraceptive supplies to prevent unintended
pregnancies; (2) Because many Americans hope to complete their families with
two or three children, many women spend the majority of their
reproductive lives trying to prevent pregnancy; (3) Research has shown that 49 percent of all large group
insurance plans do not routinely provide coverage for
contraceptive drugs and devices. While virtually all health care
plans cover prescription drugs generally, the absence of
prescription contraceptive coverage is largely responsible for the
fact that women spend 68 percent more in out-of-pocket expenses
for health care than men; and (4) Requiring insurance coverage for prescription drugs and
devices for contraception is in the public interest in improving
the health of mothers, children, and families and in providing for
health insurance coverage which is fairer and more equitable. (b) As used in this Code section, the term: (1) "Health benefit policy" means any individual or group plan,
policy, or contract for health care services issued, delivered,
issued for delivery, or renewed in this state, including those
contracts executed by the State of Georgia on behalf of state
employees under Article 1 of Chapter 18 of Title 45, by a health
care corporation, health maintenance organization, preferred
provider organization, accident and sickness insurer, fraternal
benefit society, hospital service corporation, medical service
corporation, provider sponsored health care corporation, or other
insurer or similar entity. (2) "Insurer" means an accident and sickness insurer, fraternal
benefit society, hospital service corporation, medical service
corporation, health care corporation, health maintenance
organization, or any similar entity authorized to issue contracts
under this title. (c) Every health benefit policy that is delivered, issued, executed, or renewed in this state or approved for issuance or renewal in this state by the Commissioner on or after July 1, 1999, which provides coverage for prescription drugs on an outpatient basis shall provide coverage for any prescribed drug or device approved by the United States Food and Drug Administration for use as a contraceptive. This Code section shall not apply to limited benefit policies described in paragraph (4) of subsection (e) of Code Section 33-30-12. Likewise, nothing contained in this Code section shall be construed to require any insurance company to provide coverage for abortion. (d) No insurer shall impose upon any person receiving prescription
contraceptive benefits pursuant to this Code section any: (1) Copayment, coinsurance payment, or fee that is not equally
imposed upon all individuals in the same benefit category, class,
coinsurance level or copayment level, receiving benefits for
prescription drugs; or (2) Reduction in allowable reimbursement for prescription drug
benefits. (e) This Code section shall not be construed to: (1) Require coverage for prescription coverage benefits in any
contract, policy, or plan that does not otherwise provide coverage
for prescription drugs; or (2) Preclude the use of closed formularies; provided, however,
that such formularies shall include oral, implant, and injectable
contraceptive drugs, intrauterine devices, and prescription
barrier methods. |