Departments Issue Final Summary of Benefits and Coverage Regulations

February 20, 2012 - by: Jessica Webb-Ayer 0 COMMENTS

Employers have a new health care reform deadline to add to their calendars. Last week, the Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury issued final regulations under the Patient Protection and Affordable Care Act that are intended to help:

  • individuals easily understand their health coverage and be able to pick their best coverage options; and
  • employers determine what the best coverage option is for their businesses and their employees.

Under these summary of benefits and coverage (SBC) requirements, consumers will have access to an “easy to understand” summary of benefits and coverage and a uniform glossary of terms that are frequently used in health insurance coverage (e.g., copayment and deductible).

Originally, under the proposed regulations, all health insurance issuers and group health plans would have had to provide consumers with summaries of benefits and coverage beginning March 23, 2012. However, the final regulations have changed the applicability date to September 23, 2012.

In addition to the final regulations, the departments also published helpful materials on the Employee Benefits Security Administration’s (EBISA) website. Such materials include a Guidance for Compliance document, an SBC template, a sample completed SBC, instructions for completing the SBC, HHS information for simulating coverage examples, and a uniform glossary of coverage and medical terms.

Keep up with the latest developments in employee benefits and employment law with Benefits Complete Compliance

About Jessica Webb-Ayer:
Jessica Webb-Ayer is an attorney editor for BLR’s human resources and employment law publications. She has written and edited countless publications on labor and employment law and is the editor of the Benefits Compliance Advisor online newsletter and the benefits manual, Benefits Compliance: Strategies for Plans, Programs & Policies. Ms. Webb-Ayer has also worked on various Americans with Disabilities Act (ADA) and workers’ compensation/safety products. She graduated summa cum laude with a B.A. in Psychology from Lipscomb University in Nashville, Tennessee, and graduated cum laude with a law degree from the University of Tennessee College of Law in Knoxville, Tennessee. Ms. Webb-Ayer is licensed to practice law in Tennessee.
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