Health care reform
The Patient Protection and Affordable Care Act (PPACA) requires that all employees with health insurance be given clear, consistent and comparable information about their health plan benefits and coverage. In August, the government proposed new regulations to clarify that information.
The updated rules propose two standard forms to help employees better understand and evaluate their health insurance choices:
An easy-to-understand Summary of Benefits and Coverage
This document must summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions. Consumers will receive the summary:
− When shopping for coverage
− At the time of enrollment
− At each new plan year
− Within seven days of requesting a copy from their health insurance issuer or group health plan
You can preview the proposed template here.
The new rules require that insurers provide this document and that all terms listed in it are the same across all plans. To help make sure consumers have easy access to the form, it will be posted online at HealthCare.gov.
For more details, see the government fact sheet here.
Impact on employers — Employers will look to benefits providers to supply the summary and uniform glossary prior to enrollment.
Impact on employees — These materials can help employees become more informed benefits consumers and help them understand the value of the coverage they are offered.