Human Resource Blog

WHCRA in Colorado

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How does the WHCRA impact our employees in Colorado?

The Womens Health and Cancer Rights Act does not apply to all employees in states across the country. In fact, the WHCRA applies to employees that have health care coverage plans that cover the cost of a mastectomy. These plans may or may not be offered through work. Examples of qualifying health care plans would be a group health care plan, a health insurance policy, or a plan through a Health Maintenance Organization that covers the cost of a mastectomy.

When a health care plan covers the cost of a mastectomy, the WHCRA requires that the plan cover additional benefits to the employee as well. Those benefits are available to the employee as a requirement of the WCHRA only when they are offered in connection with the mastectomy, even though the benefits may be offered for other reasons as well.

When an employee has coverage under the WHCRA, the employee will still have to pay any annual fees or deductibles that are associated with the plan and with the treatment for the mastectomy or conditions related to the mastectomy. However, the WHCRA does ensure that the employee receives at least minimum levels of treatment for conditions related to the mastectomy as well as minimum hospital stays.

The following treatments and conditions are covered by the WHCRA when they are performed in connection with the mastectomy on a covered plan:

• Treatment for complications that result from the mastectomy or resulting surgeries
• Treatment for conditions that result from the mastectomy or ensuing surgeries, such as lymphoma
• The use of a prosthetic to rebuild the breast, including the cost to implant the prosthetic
• Fees for reconstructive surgery of the breast that has had the mastectomy
• The cost for creating a symmetrical appearance between the breasts
• Protection from the employer in the event that the employer wishes to bribe the health care professionals to decrease treatment in order to save the company money. CB