HHS PS

Further to my post immediately below, a propos Tom's very welcome post a bit further down, I'll propose a slightly more generally worded variation on Tom's proposed wording:

Because we are a(n) [Name of Ecclesial Affiliation] institution, there are some devices and procedures offered by some medical providers for which we are not able, in clear conscience, to subsidize insurance coverage.  For further information please consult your insurance provider.

The private insurance provider will then be required to reply to such queries along the lines laid out in the Hawaiian provision cited below by Tom.