Under President Barack Obama’s healthcare reform law, employers and insurers must provide a summary of benefits and coverage in a clearly worded, standardized format that allows the private insurance market’s 163 million beneficiaries to make side-by-side comparisons of plan offerings.
Consumers are also required to have access to a standardized glossary of insurance and medical terms. The rule takes effect just as insurers and employers prepare for annual enrollment periods, when employees select their coverage for 2013.
The benefit guides will also factor into the creation of new state-based health insurance markets due to begin offering subsidized, private coverage to moderate-income consumers in January 2014.
The Department of Health and Human Services released an eight-page sample benefits form to demonstrate how the actual summaries will outline everything from deductibles and out-of-pocket expenses to referrals and network providers.
The guides are also supposed to show what a plan covers for two common medical situations — new births and adult diabetes.
U.S. officials compared the summaries to the Nutrition Facts label required for packaged food sold in the United States.
The rule has been criticized by the insurance industry as a new administrative burden that will increase the cost of healthcare coverage.
Copyright 2012 Reuters. Click for restrictions.Email ThisPrintNewslettersTweetCategories: National NewsTopics: buyers guide, health plan buyers guide, Patient Protection and Affordable Care ActHave a hot lead? Email us at newsdesk
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