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
- NACUBO Responds to White House College Affordability Plans
- Recommendations for Completing Form 1098-T
- Preliminary Results Show that College and University Endowments Returned 11.7 Percent in FY13
- 2014 Intermediate Accounting and Reporting - Winter
January 27-28, 2014
- 2014 Endowment and Debt Management Forum
February 5-7, 2014
- 2014 Facilities and Administrative Rates - Long Form
March 3-5, 2014
- WEBCAST: Developing a Market-Informed Approach to Tuition Pricing
Thursday, December 12, 2013 1:00 PM ET
- WEBCAST: How Behavioral Changes Helped Cut Energy Usage in Half
Wednesday, December 18, 2013 1:00 PM ET
- ON-DEMAND: Responsibility Center Management: The Process Necessary to Complete a Successful Implementation
- ON-DEMAND: OD: Responsibility Center Management: How Innovations Have Changed the Nature of RCM
- 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