In accordance with the Patient Protection and Affordable Care Act (PPACA), group health plans and health insurance issuers will begin issuing Summary of Benefits and Coverage (SBCs), starting September 23, 2012. According to Human and Health Services (HHS), this document explains “simple and consistent information about health plan benefits and coverage. People will receive the summary and glossary when shopping for coverage, enrolling in coverage, at each new plan year and within seven business days of requesting a copy from their health insurance issuer or group health plan.”
The final rule from the Department of Health and Human Services (HHS) on the Summary of Benefits and Coverage (SBC) and the Uniform Glossary requirements of the Patient Protection and Affordable Care Act (PPACA) was announced on February 9, 2012. According to the HHS, this document will explain “in plain language, simple and consistent information about health plan benefits and coverage. Starting on September 23, 2012, health insurers and group health plans will be required to provide the SBC and uniform glossary to consumers.
Because the Patient Protection and Affordable Care Act’s Summary of Benefits and Coverage (SBC) and Uniform Glossary requirements are yet to be clearly defined, the Department of Labor (DOL) submitted guidance that has delayed the effective date of these changes, therefore causing concern of a new compliance date. As described in a previous reform blog article, the SBC is intended to provide insured members with information about the plan they have or can be used when shopping for coverage and comparing plans. The Uniform Glossary is designed to help consumers have a better understanding of terminology when making a buying decision. The DOL, Internal Revenue Services (IRS) and the Department of Health and Human Services (HHS) had originally proposed March 23, 2012 as the compliance date. Due to the delay, a new compliance date is yet to be chosen. The guidance stated that, “until final rules are issued on this topic, group health plans and health insurance issuers are not required to comply.”
We are approaching another deadline for health reform, March 23, 2011. This is the date that HHS is supposed to release guidance regarding the four-page summary of benefits and coverage. Under health care reform as a part of the notification requirements, all applicants and enrollees must be provided a “summary of benefits and coverage” prior to enrollment or re-enrollment.