Several states required that health insurance policies issued in the state must provide for male sterilization or contraceptives without a deductible or with a deductible below the minimum deductible for an HSA qualifying high deductible health plan (an HDHP). Questions were raised as to whether such a requirement disqualified an individual from contributing to an HSA since the HDHP was providing coverage below the deductible. In large part due to ECFC and other industry association efforts (HSA Council), the IRS has issued guidance finding male sterilization and contraceptives to be outside the parameters of preventive care as defined for HSA purposes. However, the IRS provided liberal transition relief (until 2020) so that individuals covered by high deductible health plans that paid for male sterilization and male contraceptive expenses below the deductible will still be eligible to make contributions to an HSA. The Notice requests comments on the appropriate standards for preventive care under Internal Revenue Code section 223(c)(2)(C) (in particular, the appropriate standards for differentiating between benefits and services that would be considered preventive care and those that would not be considered preventive care) and other issues related to the provision of preventive care under an HDHP. This is important as the Treasury Department and the IRS continue to consider ways to expand the use and flexibility of HSAs and HDHPs consistent with the provisions of section 223. Notice 2018-12 can be found here.