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Women's Health and Cancer Rights Act (WHCRA) Notice

Describes mastectomy-related benefits, including reconstruction and prostheses coverage. Required annually and at enrollment.

Companies Eligible

Every group health plan that covers mastectomy — effectively every medical plan.

State law may add requirements for insured plans; the federal notice satisfies the plan's obligation.

What it is

The notice describes coverage for reconstruction of the affected breast, surgery on the other breast for symmetry, prostheses, and treatment of complications including lymphedema, subject to the plan's normal deductible and coinsurance.

What needs to be done

  • When: At enrollment and once a year. The annual notice can be a short statement in OE materials or a separate mailing; the enrollment notice must describe the benefits.
  • To whom: Participants and beneficiaries.
  • Who performs: Employer; carriers include it in insured plan certificates.
  • Customize: Plan name, a reference to the plan's deductible and coinsurance (or to the SBC and SPD), and the contact.
  • Deliver: With the enrollment packet and the annual packet. Paper by hand or first-class mail to the home always works. Electronic delivery meets the DOL safe harbor only for employees who use a computer where they work as an integral part of their duties; anyone else (spouses, former employees, employees without work computers) has to consent in advance. In July 2026 DOL proposed a notice-and-access electronic delivery safe harbor for group health plans; until it is final, these remain the rules.
  • Keep: Packet contents by year.

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