Health News
As of September 23, the ?wild west? of shopping for health insurance coverage has been at least partially tamed, thanks to the Affordable Care Act (ACA). Consumers can now get standardized, simplified summaries of benefits and coverage (SBC) that will help them understand what?s covered by an insurance policy and allow them to make apples-to-apples comparisons among plan options. These summaries are modeled on the labels we use to compare ingredients in our food, and are designed to be easy to read, with medical and insurance terms that are defined in a standard, easy-to-understand way. According to public opinion tracking polls by the Kaiser Family Foundation, this provision is one of the most popular provisions in the ACA.
For me, these forms are the culmination of hundreds of hours of effort as part of a statutory working group tasked with developing the templates for these forms. Put together by the National Association of Insurance Commissioners (NAIC), the working group represented state insurance regulators, consumers, insurance companies, health care providers and insurance brokers. We spent over a year working through the content and format of the form, and the Obama Administration adopted our recommendations with very few changes.
The U.S. Department of Health and Human Services (HHS) notes the following important details about the SBC:
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Health News
Summaries of Benefits and Coverage: Simplifying Shopping for Health Insurance
As of September 23, the ?wild west? of shopping for health insurance coverage has been at least partially tamed, thanks to the Affordable Care Act (ACA). Consumers can now get standardized, simplified summaries of benefits and coverage (SBC) that will help them understand what?s covered by an insurance policy and allow them to make apples-to-apples comparisons among plan options. These summaries are modeled on the labels we use to compare ingredients in our food, and are designed to be easy to read, with medical and insurance terms that are defined in a standard, easy-to-understand way. According to public opinion tracking polls by the Kaiser Family Foundation, this provision is one of the most popular provisions in the ACA.
For me, these forms are the culmination of hundreds of hours of effort as part of a statutory working group tasked with developing the templates for these forms. Put together by the National Association of Insurance Commissioners (NAIC), the working group represented state insurance regulators, consumers, insurance companies, health care providers and insurance brokers. We spent over a year working through the content and format of the form, and the Obama Administration adopted our recommendations with very few changes.
The U.S. Department of Health and Human Services (HHS) notes the following important details about the SBC:
- The provision applies to ALL health plans, whether you get coverage through your employer or purchase it directly, starting September 23, 2012.
- Insurers need to provide the SBC to consumers at the time they apply for coverage, and to enrollees upon renewal.
- The form includes coverage scenarios for two common situations: normal delivery of a baby and treating type 2 diabetes. These scenarios can give interested consumers an approximate picture of their future out of pocket costs under the policy.
- Non-English speakers can request the SBC in their native language ? insurers are required to translate the form into common languages such as Spanish and, in some states, Chinese, Tagalog and Navajo.
For information on developments like this?and much more?be sure to check in with CHIRblog?s series on ?Implementing the ACA.?
Sabrina Corlette
Georgetown University Center on Health Insurance Reforms
Georgetown University Center on Health Insurance Reforms
(This blog was originally posted on the Center on Health Insurance Reforms blog site here )
- What Health Reform Changes To Expect In 2012 ? Assuming The Supreme Court Doesn't Strike Down The Entire Law
The U.S. Supreme Court is set to hear arguments later this month about the federal health care-reform law, and is expected to decide the law's future this summer. While the court mulls the constitutionality of an individual mandate to buy health insurance,...
- Doi Moves To Allow Consumers To Continue Current Coverage Into 2014
The Illinois Department of Insurance (DOI) announced on November 22 that it will follow President Obama?s November 14 recommendation and allow insurance companies to renew a number of health plans in the individual and small group markets that do not...
- Clearing Up The Facts
There has been a lot of confusion about some recent notices to consumers from insurance companies that sell coverage in the individual insurance market, and I?d like to clear up the facts. Today, more than 3 out of every 4 Americans get insurance from...
- Making The Grade: A Scorecard For State Health Insurance Exchanges
According to the Illinois Department of Insurance, health insurance premiums have risen on average 181 percent since 2005. This could be the week action is taken in Illinois to fix our health insurance marketplace for Illinois families and small businesses....
- It?s Finally Happening
A legislative taskforce is working right now on ways to increase competition in the Illinois health insurance marketplace, and they?ll make recommendations by September 30th. Insurance lobbyists have come to Springfield to prevent anything that might...