Administration increases transparency for consumers shopping for health insurance coverage

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June 12, 2015                                                                                                                          

 

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Administration increases transparency for consumers shopping for health insurance coverage

Final rules are designed to improve consumers’ access to important plan information

The Departments of Health and Human Services (HHS), Labor, and the Treasury today issued final regulations to make it easier for people and employers to compare their options when shopping for and renewing health insurance coverage.  These rules also implement streamlined processes to help health insurance issuers and group health plans provide consumers easy to understand information. 

 “The Administration is committed to improving the information consumers receive when shopping for health care coverage so they can make informed choices for themselves and their families,” said Acting CMS Administrator Andy Slavitt.  “These clarifications will also make it easier for issuers and group health plans to provide the most accurate health coverage information to consumers.”

The rules enhance the consumer shopping experience in a number of ways.  For example, health insurance issuers must provide online access to a copy of the individual coverage policy for each plan or group certificate of coverage.  And these documents must be made publicly available to all potential consumers prior to when a consumer applies, so they are clearly informed about what a plan will and will not offer.  The final rules make few changes to the rules proposed in December 2014.

In continuing the goal of providing clear and straightforward information to consumers about health plans available in their area, health insurance issuers and group health plans must still provide a brief SBC that includes coverage examples and a uniform glossary to consumers.  Revisions to the SBC, coverage examples, and uniform glossary are anticipated to be finalized by January 2016 after the Departments utilize consumer testing and receive additional input from the public, including the National Association of Insurance Commissioners (NAIC).  The revisions will apply to SBCs for coverage beginning on or after January 1, 2017.  

To view the Final Rules, visit: https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-14559.pdf And on 06/16/2015 it is scheduled to be published and available here: https://www.federalregister.gov/articles/2015/06/16/2015-14559/summary-of-benefits-and-coverage-and-uniform-glossary

 

For more information on the final rules announced today, visit: http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/Fact-Sheet_SBCFinalRule-6-11-15-MM-508.pdf