RAHWAY — Democrat James J. Devine said new regulations published pursuant to the Affordable Care Act – President Barack Obama’s signature health reform law – will require insurance companies to provide consumers with clear, understandable and straightforward information about coverage and costs.
“For many years, complex legal documents were routinely issued with policies, leaving consumers confused about what they were buying,” said Devine. “Such convoluted marketing materials provided by insurance companies often made it difficult for consumers to understand what health plans covered, what limitations or conditions apply, and what patients would pay for services.”
Devine said the new rules, published jointly by the federal departments of Health and Human Services (HHS), Labor and Treasury, require insurers to provide concise and comprehensible information about benefits and coverage to the millions of Americans with private health coverage.
“The new rules will also make it easier for people and employers to directly compare one plan to another,” said Devine.
“All consumers, for the first time, will really be able to clearly comprehend the sometimes confusing language insurance plans often use in marketing,” said HHS Secretary Kathleen Sebelius. “This will give them a new edge in deciding which plan will best suit their needs and those of their families or employees.”
Specifically, the new regulations finalize rules proposed in August 2011 and will ensure consumers have access to two key documents that will help them understand and evaluate their health insurance choices:
• A short, easy-to-understand Summary of Benefits and Coverage (SBC); and
• A uniform glossary of terms commonly used in health insurance coverage, such as “deductible” and “co-payment.”
All health plans and insurers will provide an SBC to shoppers and enrollees at important points in the enrollment process, such as upon application and at renewal.
A key feature of the SBC is a new, standardized plan comparison tool called “coverage examples,” similar to the Nutrition Facts label required for packaged foods.
The coverage examples will illustrate sample medical situations and describe how much coverage the plan would provide in an event such as having a baby (normal delivery) or managing Type II diabetes (routine maintenance, well-controlled).
“These examples will help consumers make informed buying decisions so they understand each plan they may be considering and they can get what they pay for,” said Devine.
Connect with NJTODAY.NET
Join NJTODAY.NET's free Email List to receive occasional updates delivered right to your email address!