Human Resource Blog

WHCRA in Connecticut

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What do we need to know about the WHCRA in Connecticut?

The Womens Health and Cancer Rights Act is a federal Act that may apply to employees in companies across the country. However, unlike many other federal Acts that impact employers, the WHCRA may not necessarily impact the employer. Instead, the WHCRA largely impacts the health care coverage companies.

When an employee has a health care coverage plan, either through work or that the employee obtained independently, the employee may receive coverage under the WHCRA for treatments that are associated with a mastectomy. All employees that have a health care coverage plan that covers a mastectomy are required to also receive benefits for other conditions.

While these other benefits may be desired by the employee for any reason, they are only covered by the WHCRA when they are directly associated with a mastectomy. The WHCRA benefits may include the following:

·         Coverage for treatment that may be needed as a result of complications of the mastectomy or related treatments.

·         Coverage for conditions that could occur as a result of the mastectomy or related treatments, including coverage for lymphoma

·         Reconstructive surgery of the breast that has had the reconstructive surgery

·         Reconstructive surgery that may be desired in order to create a symmetrical appearance between the breasts

·         Optional surgery that may be needed to implant a prosthetic, including the cost of the prosthetic

Employees will still need to pay annual fees and deductibles for their treatments, even if those treatments are covered by the WHCRA. Also, employees should receive notification of their rights under the WHCRA from the health care company directly. The health care company is required to send the patient information about the WHCRA rights when the employee signs up for a policy as well as on an annual basis for as long as the employee has a policy. CB