A Standard Clause for use by health insurers and third-party administrators (TPAs) of health plans to inform plan participants and beneficiaries of the availability of separate payments for contraceptive services under the Affordable Care Act (ACA). The notice of availability of separate payments relates to an accommodation (now optional) for entities that object, based on sincerely held religious beliefs, to providing contraceptives as required under the ACA. The accommodation was made available by the federal agencies for employers and other entities with religious objections to offering contraceptive services.