New HHS Regulations Will Significantly Improve Consumer Understanding of Health Plans

Today, the Departments of Health and Human Services, Labor, and Treasury jointly released the final regulations for the Summary of Benefits and Coverage requirements in the Affordable Care Act, which require all private insurers to provide clear, concise, and uniform information about the benefits, limitations, and costs under a plan for all plans issued on or after September 23, 2012. The following is the statement of Ron Pollack, Executive Director of Families USA, on the new regulations:

“The Summary of Benefits and Coverage final regulation will significantly improve consumer information in the health care marketplace. This standard disclosure will give consumers the information they need to compare health plans and choose the best coverage for themselves and their families.

“We are pleased that all individual and group insurance plans will begin providing this standard disclosure to consumers later this year, and that the disclosure will include examples of how plans provide coverage for pregnancy and Type II diabetes. We also are pleased that the new regulations state that additional coverage examples will be required in the future.

“Consumers' ability to make informed health care choices is at the foundation of creating the type of health insurance marketplace envisioned by the Affordable Care Act—a marketplace that is transparent, fair, and competitive. We look forward to working with the administration to implement the new requirements, inform consumers about their new rights, and continue to improve the information available to consumers about their health insurance options.”

Pollack noted that, under the rule, insurers will not be required to provide a paper copy of the form. Instead, consumers will receive notice that the form is available online and in paper form only upon request. Pollack would like to see insurers provide a paper copy with marketing materials and enrollment applications. He said he hopes further steps will be taken to ensure that all consumers are aware of their new right to the Summary of Benefits and Coverage and are able to easily obtain and use the new disclosure.

Pollack also said he hopes requirements to provide translations of the Summary of Benefits and Coverage into languages other than English and to provide oral translation assistance will be strengthened.

###

Families USA is the national organization for health care consumers. It is nonprofit and nonpartisan and advocates for high-quality, affordable health care for all Americans.

1201 New York Avenue NW, Suite 1100 · Washington, DC 20005
202-628-3030 · Email: info@familiesusa.org · www.familiesusa.org