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  • Proposed Rules for Summary of Coverage Available

    In follow up to our post from August 18, 2011, the departments of Labor and Health and Human Services (with the
    Treasury) laid out the new proposed rules for the “uniform summary of coverage” that is required under PPACA.   Health insurers and group health plans have to provide consumers with clear, consistent and comparable information about their health plan benefits and coverage starting in 2012.

    All health plans and issuers would provide a summary of benefits and coverage, along with a glossary of terms to employees before enrollment.  Health plans and issuers will also provide notice at least 60 days before any significant modification is made in the plan or coverage during the plan or policy year.  The summary of benefits coverage would be some simple standard boxes for comparison shopping. If the exchanges are in place by 2014, this would allow an employee to compare employer sponsored coverage against other market-available options.

    As these are merely proposed, there is nothing final and employers do not have to immediately act, nor can then act until the proposed
    uniform definitions are drafted. But employers and plan sponsors should keep this information handy as a reference point for developing a long-term compliance strategy.

    For more details about the proposed regulations, please go to the dol website at www.dol.gov.

     

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