by Jason Coon
As regulations affecting Catholic employers continue to evolve, the Catholic Benefits Association (CBA) remains committed to keeping its members informed. The year 2024 has been especially active with federal health plan mandates, which have resulted in new procedures and compliance challenges for Catholic employers.
CBA’s role extends beyond information-sharing; we also analyze how new regulations are enforced and translated into practical processes. When mandates impact employer obligations or insurance procedures, we offer guidance and support to help members uphold their mission while remaining compliant with federal requirements.
If you receive notices from government agencies, health insurers, Third-Party Administrators (TPAs), or Pharmacy Benefit Managers, we urge you to contact us. Your insights help us better serve the community and provide the necessary support.
Health Care Regulation Updates
Recent health plan mandates have triggered several changes that may require employers to take action. Below are two key updates that could affect your organization.
1. Section 1557 Compliance
The Department of Health and Human Services (HHS) has finalized a rule for 2024 that affects Section 1557 of the Affordable Care Act (ACA). Several health plan carriers are now issuing compliance notices related to this rule.
What’s Happening?
Carriers are sending notices to employer groups that do not cover Gender Transition / Gender Affirming Care services, warning that their health plans may be non-compliant. The notices often recommend that groups seek legal guidance. In response to the rule, many carriers have begun updating their care standards, sometimes covering gender-affirming services with no age restrictions.
What Should CBA Members Do?
CBA members are protected from this regulation under CBA’s customized protection framework. To safeguard our members, CBA has created updated protection letters in response to the Section 1557 regulatory changes. These letters will soon be distributed to all members.
If you receive a compliance notice from your insurer, take these steps:
- Notify your legal counsel to ensure appropriate action is taken.
- Send the insurer or TPA a copy of your updated CBA protection letter.
- Contact CBA for support if you have questions or concerns regarding the notice or your protection.
2. HIPAA Privacy Rule to Support Reproductive Health Care Privacy
The Supreme Court’s June 2022 Dobbs decision prompted HHS to reevaluate how reproductive health care information is handled under HIPAA. In response, HHS has issued new privacy rules to protect Personal Health Information (PHI) related to reproductive health care.
What’s Changing?
HHS now prohibits the disclosure of PHI if it is being sought for the purpose of investigating or penalizing someone for “seeking, obtaining, providing, or facilitating” reproductive health care. These terms are broadly defined, with “reproductive health care” covering any health care related to the reproductive system. This definition also encompasses activities like expressing interest in, arranging, paying for, or insuring such services.
How Does This Affect CBA Members?
Insurers and TPAs are now requiring updates to Business Associate Agreements (BAAs) to incorporate the new PHI protection language. Many CBA members have already reported receiving requests to sign these revised agreements ahead of the compliance deadline of December 23, 2024.
What Should CBA Members Do?
To ensure compliance with HIPAA’s updated privacy rule while maintaining Catholic values, CBA recommends the following steps:
- Understand the new definition of “reproductive healthcare.” This definition includes services like abortion and infertility treatments that conflict with Catholic teachings.
- Review new Business Associate Agreements carefully. Pay close attention to sections related to PHI privacy.
- Leverage CBA’s resources. CBA offers free, detailed health plan reviews to help members identify areas of potential non-compliance.
- Sign updated BAAs with confidence. There should be no issue signing new agreements since CBA’s protections remain in place. If you have concerns, reach out to us for guidance.
Ongoing Monitoring of Regulatory Changes
Federal regulations are constantly evolving, and each new rule may trigger changes in processes enforced by insurers and TPAs. CBA’s team remains vigilant in tracking these changes, analyzing how they affect our members, and providing timely updates.
We also recommend that members stay alert for communications from insurers and TPAs, as they often implement changes ahead of official deadlines. If you have questions about any correspondence, CBA is here to help.
How CBA Helps You Protect Your Mission
The growing complexity of health care regulations requires employers to be proactive in reviewing health plan documents, BAAs, and vendor agreements. Without consistent monitoring, new mandates could compromise Catholic principles or introduce legal risks.
To help members address these challenges, CBA offers health benefits consultation services. These consultations provide:
- Detailed plan reviews to ensure compliance with CBA’s protection framework.
- Advice on responding to insurer notices and regulatory updates.
- Ongoing support to protect your mission and Catholic identity.
If you’d like to learn more about how CBA can support your organization, please contact:
Jason Coon, Vice President
📞 (720) 660-7260
CBA remains committed to helping Catholic employers navigate the regulatory landscape while protecting their religious identity. If you have any questions or concerns regarding compliance issues, please don’t hesitate to reach out.