The Departments of Health and Human Services, Labor, and Treasury published final regulations that require health insurers to eliminate technical or confusing language from their marketing materials.
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Download NowUnder the rule announced today, health insurers must provide consumers with clear, consistent, and comparable summary information about their health plan benefits and coverage. The new forms are expected to be available beginning, or soon after, September 23.
Specifically, these rules will ensure consumers have access to two key documents that will help them understand and evaluate their health insurance choices:
- A short, easy-to-understand Summary of Benefits and Coverage ( or “SBC”); and
- A uniform glossary of terms commonly used in health insurance coverage, such as “deductible” and “co-payment.”
All health plans and insurers will provide an SBC to shoppers and enrollees at important points in the enrollment process, such upon application and at renewal. In the past, health insurers would only provide selective details on a policy before it was purchased.
A key feature of the SBC is a new, standardized plan comparison tool called “coverage examples”. The coverage examples will illustrate sample medical situations and describe how much coverage the plan would provide in an event such as having a baby (normal delivery) or managing Type II diabetes (routine maintenance, well-controlled).
Today’s rules finalize the proposed rules issued in August 2011. More information is available on www.healthcare.gov.