Letter to Employment Benefits Security Administration on Delta Air Lines employee insurance coverage of PrEP
U.S. Department of Labor
Subject: Delta Air Lines Employee Plan Coverage of HIV Pre-Exposure Prophylaxis
Via: EBSA Online Complaint Portal
The HIV+Hepatitis Policy Institute is a national, non-profit organization whose mission is to promote quality and affordable healthcare for people affected by HIV, hepatitis, and other serious and chronic health conditions.
We urge you to investigate Delta Air Lines, which is failing to cover HIV Pre-Exposure Prophylaxis (PrEP) medications in some or all of its employee health plans, as required by law. Included as part of this complaint is an image of a notice sent to an enrollee indicating that Descovy, a daily oral PrEP drug, will no longer be covered by Delta’s health insurance plan beginning on August 1, 2025. This change affects all enrollees (employees and their family members).
Under section 2713 of the Affordable Care Act, non-grandfathered private insurance plans have been required to cover PrEP medication and associated services without cost-sharing since the United States Preventive Services Task Force (USPSTF) recommended PrEP with an “A” rating in 2019 (https://bit.ly/3GRsGtw). The USPSTF updated this recommendation in 2023 to include new PrEP options including Descovy and a new long-acting injectable (https://bit.ly/4lEL3Bd). Non-grandfathered plans have been required to comply with this updated recommendation for all plan years beginning after August 31, 2024.
In October 2024, the Departments of Labor, Health and Human Services and Treasury issued coverage guidance confirming that all PrEP medications and services must be covered without cost-sharing. In addition, it makes clear that prior authorization is not allowed for the purpose of steering PrEP users to a specific drug (https://bit.ly/3Uiv2EK).
Delta’s employee plans are non-grandfathered self-insured plans which use CVS Caremark as its pharmacy benefits manager.
With approximately 100,000 employees in the United States, Delta must not be allowed to end coverage of a drug for the prevention of HIV in clear violation of federal law and implementing guidance. With the state of Georgia facing one of the highest HIV burdens in the country, and Atlanta among the top cities for new diagnoses, it is critically important for Delta’s employees and family members and the communities they live in for the Department of Labor to investigate Delta Air Line’s coverage of PrEP and enforce the law.
We urge you to quickly investigate and resolve this matter to ensure that Delta is complying with the law and covering all forms of PrEP drugs, including the newest long-acting drugs, without cost-sharing.
If you have any questions, comments, or would like to discuss these issues further, please contact Carl Schmid, Executive Director, HIV+Hepatitis Policy Institute at cschmid@hivhep.org or (202) 462-3042, or Kevin Herwig, Health Policy Manager, HIV+Hepatitis Policy Institute at kherwig@hivhep.org or (617) 666-6634.
Sincerely,
Carl Schmid
