The New, Fun SBC Requirement

[insurehound]

Have you dug into the new Summary of Benefits & Coverage Requirement? Oh joy.

How much of this will you take on for your clients? Are you using letters, emails or phone calls to communicate this new requirement?

I see a lot of opportunity for fines. Like small businesses don't have anything better to do.

 

[ABC]

So far I am seeing the carriers developing a digital platform.

The group goes onto the platform and clicks to send out the SBC.

This is not going to be a broker responsibility unless you choose to take it on.

 

[leevena]

This is not a responsibility of the broker. Law clearly puts the responsibility on the carrier or issuer. Even if you decide to take this on, I doubt if the carrier would allow you to do so.

 

[insurehound]

Actually Aetna has provided information for the Broker should he or she decide to take it on.

ABC, Leevena, are you or will you take this on? My concern is if I do, then of course that opens us up to fines. If we don't, other agents will step in take the business.

 

[leevena]

Actually Aetna has provided information for the Broker should he or she decide to take it on.

ABC, Leevena, are you or will you take this on? My concern is if I do, then of course that opens us up to fines. If we don't, other agents will step in take the business.

Exactly my point. The law clearly states who is responsible and why you would want to take on the risk is beyone me. You may want to check with your E&O carrier for their input too.

Besides, how would an agent/broker help? If the carrier is doing this what could you do?

 

[Ann H]

It's very confusing. Just 3 days before the 9/23/2012 deadline I received an email from Aetna asking for broker assistance in delivering the SBCs, and stating that they will monitor the situation to make sure we are giving the assistance. At the same time, I was receiving alerts from other carriers explaining their digital platform, but mentioning no required broker involvement.

 

[insurehound]

Exactly my point. The law clearly states who is responsible and why you would want to take on the risk is beyone me. You may want to check with your E&O carrier for their input too.

Besides, how would an agent/broker help? If the carrier is doing this what could you do?

How about ordering/retrieving SBCs for the Group for a new employee or new group, helping them customize and distribute the SBCs to their employees.

http://www.aetna.com/externalweb/documents/SBCBrochure.pdf

 

[leevena]

How about ordering/retrieving SBCs for the Group for a new employee or new group, helping them customize and distribute the SBCs to their employees.

http://www.aetna.com/externalweb/documents/SBCBrochure.pdf

sounds like you are doing the HR job at the employer. similar to cobra I guess, brokers do it. But I would not design/develop and produce the document.

 

[insurehound]

I'm not doing anything. I'm still just weighing my options. I don't do Cobra either...

 

[Yagents]

This from an agency here in town (Black & Gould)

[FONT=Georgia, Times New Roman, Times, serif][FONT=Calibri, Helvetica, Arial, sans-serif]Who is responsible for creating and distributing the SBC?[/FONT][/FONT]
[FONT=Calibri, Helvetica, Arial, sans-serif]Creating the SBC document is generally the responsibility of the Insurer (carrier) for fully-insured group and individual health plans and the Insurer/Third Party Administrator (TPA) for self-insured health plans. Distributing the SBC is generally the responsibility of the Insurer for individual plans, the Insurer and Employer for fully-insured group plans, and the Insurer and TPA for self-insured health plans. However, several insurance carriers have specified that the Insurance Broker also shares responsibility for distribution.[/FONT]