The Obama administration last week published final regulations detailing the new health insurance summaries that the federal health law requires plans to give to consumers to help them make informed coverage choices.
Under the new rules, health insurers must provide consumers with clear, consistent and comparable summary information about their health plan benefits and coverage. The new explanations will be available beginning, or soon after, September 23, 2012.
Specifically, these rules will ensure consumers have access to two key documents that will help them understand and evaluate their health insurance choices: a Summary of Benefits and Coverage and a Glossary of Health Coverage and Medical Terms.
All health plans and insurers will provide a summary of benefits to shoppers and enrollees at important points in the enrollment process, such as upon application and at renewal.
A key feature of the summary of benefits and coverage notices is a new, standardized plan comparison tool called “coverage examples,” similar to the nutrition facts label required for packaged foods. 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 or managing Type II diabetes. These examples will help consumers understand and compare what they would have to pay under each plan they are considering.
Click to view the template for the Summary of Benefits and Coverage and the Glossary of Health Coverage and Medical Terms, and click here to view the final rule.
Leave a Reply