Health Care Reform Update: Benefit Summary Standards Proposed
August 25, 2011
Proposed regulations were released August 22 that would set disclosure requirements and standardize presentation of summaries of benefits and coverage for group and individual health plans. Two Federal Register notices were published jointly by the Internal Revenue Service, the Employee Benefits Security Administration, and the Centers for Medicare & Medicaid Services. The first notice proposes standards for group health plans, including self-insured plans, and health insurance issuers that would govern who must provide and who should receive a summary of benefits and coverage, and how and when it must be provided. The second notice provides the proposed template and instructions for the summary, samples, and a proposed uniform glossary of terms.
The standards are intended to lead to effective communication about each plan and make it easier to compare benefits and costs across plans. The Affordable Care Act directed the agencies to ensure that summaries of benefits and coverage:
- Be presented in a uniform format;
- Utilize terminology understandable by the average plan enrollee;
- Are no more than four pages long (which, after taking into account the amount of information required, the agencies have interpreted as four double-sided pages); and
- Use type no smaller than 12 points.
In addition, the agencies were also charged with developing a glossary of terms to engender a common understanding of typical health insurance language.
As directed by the law, the agencies relied heavily on the National Association of Insurance Commissioners (NAIC), which convened a working group comprised of various stakeholders to develop the proposed standards and templates. The NAIC process included the opportunity for public comment.
Comments on the proposed rules are due October 21. Once the rules are finalized, group health plans and health insurance issuers will need to comply beginning March 23, 2012, two years after enactment of the Affordable Care Act.
Director, Environmental Leadership
Vice President, Regulatory Affairs
- Federal Education Budget Limited by Spending Caps
- Lawmakers Ease 1098-T Penalty Enforcement
- EPA Announces Athletic Conferences With Most Green Power
- 2015 CAO and CBO Collaborations
August 3-4, 2015
- 2015 Planning and Budgeting Forum
September 28-29, 2015
- 2015 Tax Forum
October 25-27, 2015
- WEBCAST: Developing Your Campus Distance Learning Strategy
Wednesday, August 12, 2015 1:00PM ET
- WEBCAST: Legislative Lunchcast: A 30-Minute Washington Update from NACUBO
Wednesday, September 9, 2015 12:00PM ET
- ON-DEMAND: A Just-in-Time Webcast to Explain FASB’s NFP Reporting Proposal
- ON-DEMAND: Decoding ED's Cash Management Proposal
- ON-DEMAND: Corporate Sponsorships: Getting it Right
- ON-DEMAND: Analytics that Support Planning, Budgeting, and Results
- A Guide to College and University Budgeting: Foundations for Institutional Effectiveness, 4th ed. - by Larry Goldstein
- NACUBO's Guide to Unitizing Investment Pools - by Mary S. Wheeler
- Managing and Collecting Student Accounts and Loans - by David R. Glezerman and Dennis DeSantis