Human Resource Blog

WHCRA in Florida

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How are we to provide benefits to our companies according to the WHCRA in Florida?

Employers that offer their employees group health care [plans that cover the cost of a mastectomy may be covered by the Womens Health and Cancer Rights Act. However, the WHCRA applies more to health care coverage companies than it does to employers. The WHCRA specifically affects employers because it does not allow employers to bribe health care professionals to provide a diminished level of treatment or to reduce the hospital stay of an employee in order to save the company money.
The WHCRA applies to all health care plans that provide coverage for mastectomies to their policy holders. These health care plans may include group health care plans that are provided by the employer, but they can also include Health Maintenance Organizations and health insurance policies that the employees take out independently of the employer.
When the WHCRA comes into play, a health care coverage provider needs to already provide coverage for a mastectomy to its policy holders. As long as the plan already provides coverage for a mastectomy, the health care provider is also required to offer additional treatments and benefits to the employee. However, these benefits are only covered by the WHCRA if they are directly associated with the health care plan. Those benefits may include:
• Reconstructive surgery of the breast that has had a mastectomy
• Reconstructive surgery of the breast if the additional surgery is needed to create a symmetrical appearance between the breasts
• The implantation and purchase of the prosthetic breast
• Treatment for complications that may arise from either surgery
• Treatment for conditions that may occur as a result of the mastectomy or surgeries, such as lymphoma
Also, according to the WHCRA, employees are still required to pay any annual fees as well as deductibles for the surgery or treatments, just as they would with any other health care need that they have. CB