Summary of Benefits and Coverage

[ABC]

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I could have posted this in Health Insurance Reform but I choose here in stead.

This blog post is about providing the employees a SBC or face paying a fine. I have to admit this is the first I have heard of this.


Thoughts?

 

[STIBROKER]

Get Ready To Read Those Labels!

 

[LOM58]

Seems to be redundant and another burden placed on insurers that will add to the cost of health insurance. Basically, status quo Obamacare.

 

[stuy119]

Received a newletter on this topic today from one of my GA's. This was something I was unaware of, and need to see how it's handled. (paraphrased from the FAQs from the Center for Consumer Information and Insurance Oversight)

Q6: If plan offers participants add-ons to major medical coverage that could affect their cost sharing and other information in the SBC (such as an FSA, HRA, HSA or wellness program), is the the plan permitted to combine information for all of these add-ons and reflect them in a single SBC?

A6: Yes. As stated in the preamble, plans and issuers are permitted to combine such information in one SBC, provided the appearance is understandable.

This is going to be a mess for companies that provide HSA funds or HRA dollars. I'm glad that it says it's "permitted" and not "required" to be on the same SBC.

 

[leevena]

I could not access your link to the blog. There are significant issues for all parties (brokers/employers/insurers/tpa's) involved. Rules and oversight are spread between DOL, HHS, and Treasury and there may be some impact at the State level.

It essentially requires an easy to read/understand document for communicating benefits to an employee, which sounds simple enough. The government has issued a standard format, uniform definition of insurance/medical terms, formatting guides, sample of coverage examples, culturally and linguistically appropriate, and other instructions.

These requirements begin with groups that have their first open enrollment beginning on/after Sept 23.

If you cannot find the information, feel free to send me an email and I will forward to you the documents that I have.

Hope this helps.