Document ID: ./input/supremecourt_opinions/opinions/13pdf/13a1284_ap6c.pdf
Page Number: 5

Cite as:  573 U. S. ____ (2014) 

5 

SOTOMAYOR, J., dissenting 

omitted).  As a practical matter, the provision ensures that
women  have  access  to  contraception  at  no  cost  beyond 
their insurance premiums.  Employers that do not comply 
with the mandate are subject to civil penalties. 

Recognizing  that  some  religions  disapprove  of  contra-
ceptives,  the  Government  has  sought  to  implement  the 
mandate  in  a  manner  consistent  with  the  freedom  of 
conscience. 
It  has  categorically  exempted  any  group
health  plan  of  a  “religious employer,” as defined by  refer-
ence  to  the  Tax  Code  provision  governing  churches.    See 
45  CFR  §147.131(a);  http://hrsa.gov/womensguidelines  (as 
visited July 2, 2014, and available in Clerk of Court’s case
file).  And  it  has  extended  a  further  accommodation  to 
religious  nonprofits  that  do  not  satisfy  the  categorical 
exemption.  All agree that Wheaton qualifies as a religious 
nonprofit.

To  invoke  the  accommodation  and  avoid  civil  penalties,
a religious nonprofit need only file a self-certification form
stating (1) that it “opposes providing coverage for some or
all  of  any  contraceptive  services  required  to  be  covered
under  [the  regulation]  on  account  of  religious  objections,”
(2) that  it  “is  organized  and  operates  as  a  nonprofit  en-
tity,” and (3) that it “holds itself out as a religious organiza- 
tion.”  §147.131(b).  The form is reprinted in an appendix 
to this opinion.  Any organization that completes the form
and  provides  a  copy  to  its  insurance  issuer  or  third-party
administrator1  need  not  “contract,  arrange,  pay,  or  refer 
for  contraceptive  coverage”  to  which  it  objects.    78  Fed. 
Reg. 39874 (2013); see 29 CFR §2590.715–2713A(b)(1) and 
(c)(1).  Instead, the insurance issuer or third-party admin-

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1 Typically, an employer contracts to pay  a health insurer to provide 
coverage;  the  insurer  both  covers  the  cost  of  medical  claims  and  man-
ages  the  process  for  administering  those  claims.    Employers  who
maintain  self-insured  plans  cover  the  cost  of  claims  for  medical  treat-
ment directly.  Such employers often contract with third-party adminis-
trators to administer the claims process.