Summary of Benefits Mandate - Effective September 2012.
- Thread starter AllenChicago
- Start date
Zane Benefits
Expert
Proud to say we've released SBC for our Health Reimbursement Arrangement (HRA) offering, ZaneHRA! 
IndianaHealthAgent
Expert
- 26
Proud to say we've released SBC for our Health Reimbursement Arrangement (HRA) offering, ZaneHRA!
In the case of a group plan with an HRA, how are you guys integrating the HRA SBC with the insurance carrier SBC?
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Blue Cross of Illinois sent out an e-mail on 10/26/2012 stating that due to technical challenges, they do not yet have the Summary of Benefits available for existing customers. They will let us know when they do.
If setting up the software to match a one-page SOB up with each customer's policy is a challenge, imagine the intricacies involved with calculating subsidies and correctly billing each customer who buys a plan on one of the new exchanges in 2014. I suppose BCBS will work with the IRS, which means that BCBS will make a lot of customers angry due to the IRS providing incorrect and/or delayed income information. Lots of finger pointing while the customer gets sick with no active insurance policy.
I don't think that carriers will really be involved in calculating the subsidies anyway - that's the responsibility of the exchange, and also the reason that I think a lot of states will end up with a partnership with HHS initially so that HHS has to deal with the backend technology.
Carrier should just have to plug in their plans and rates....
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- #24
- 8,448
I sincerely hope that the Affordable Care Act requires that "Summary of Benefits" continue to be provided by health insurers from their 2014 plans. I will need to use these SOB's to help me VISUALLY explain to clients how the plans work.
After running a quote at the enhanced Covered California website this evening, it's apparent that the 2014 Bronze/Silver/Gold/Platinum plans are more complex/confusing than pre-2014 major medical policies.
Check it out: Get Covered | Covered California™
ac
After running a quote at the enhanced Covered California website this evening, it's apparent that the 2014 Bronze/Silver/Gold/Platinum plans are more complex/confusing than pre-2014 major medical policies.
Check it out: Get Covered | Covered California™
ac
This looks pretty straight forward and easy to me but I've always taken the time to review the plan details with clients before enrolling them.
They still don't remember anything other than their office copay and possibly their deductible but it makes me feel better
- 2,172
Yes, summary of benefits are still required. I will also need them after seeing the 39 or so different plans Florida Blue finally put in access blue Friday. The summary of benefits the loaded are easier to explain than using the matrices. I imagine I'll be using mostly bronze and silver cost sharing plans in my area rather than anything else.
Thanks for the heads up on the Benefit summaries now being on Access Blue-they also have the rate sheets for two plans sold Off Exchange in a separate document, based on the best comparison I can make for the Silver HSA plan vs the closest HSA plan now available (there is no exact match) it looks like about a 30%% rate increase.
Overall, I like the new plan benefit structures, they are easier to understand and will be attractive for those in the subsidy range since several of them offer $0 copays for Primary Care visits and much lower deductibles and copays for brand name drugs.
The bottom line for all of this is that if consumers like the plans and get reasonable premiums after subsidies they will flock to enroll-it looks to me like Florida Blue has done a good job with this.
Who knows what will happen in the future, of course...
- 2,172
Yep, they have done a good job and since there is so much to absorb in the seminar's I believe they said we are the only company on the exchange in 37 or 39 counties, can't remember. I know two of the counties I work only offer Blue on the exchange. The one my office is located in is Blue, Aetna and Coventry. I had figured Humana would be in the panhandle but guess not. They have a small corporate office in Pensacola also. There Med Advantage is down to one hospital. One dropped them August 1 and I have written a few LIS since. They may as well close up shop up here. I'll have to go check access blue didn't see the off exchange plan rates. They brought the plans online early Friday morning and must be working on the rest all weekend.
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- Thread starter
- #29
- 8,448
February 26, 2016
If ObamaScrew isn't in the process of being intentionally dismantled in 2017, a new Summary of Benefits document will replace the current one.
Story: HHS, Labor, And Treasury Propose Revised Summary Of Benefits And Coverage Template
If ObamaScrew isn't in the process of being intentionally dismantled in 2017, a new Summary of Benefits document will replace the current one.
Story: HHS, Labor, And Treasury Propose Revised Summary Of Benefits And Coverage Template
- 2,172
Allen, didn't read the whole thing but a glossary of medical terms? Lol, in 2018 they will require to include a tongue depressor, bp cuff and other medical related items, by 2020 everyone will be paying high premium's and self treating themselves. Can't wait to tell a male client they will receive a big finger in their insurance package to do their own DRE each year.
Where does this madness stop?
Where does this madness stop?
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