Thursday, August 18, 2011

Another day, another ACA regulation

Yesterday, the Affordable Care Act regulators proposed a rule governing the four [double sided] page summary of benefits and glossary of health insurance terms that health plans must prepare once the rule is finalized and make available to plan participants and beneficiaries.  The Labor Department's Affordable Care Act website provides all of the documentation, including the template for the summary of benefits and related instructions.

The FEHBlog is still reviewing the regulation and sub-regulatory guidance which run over 200 pages. At first blush, the glossary appears to duplicate what's already found in health plan brochures / summary plan descriptions. The FEHBlog wonders why Congress didn't require the medical community to create a
glossary for patients.

America's Health Insurance Plans, the health insurers' trade association, commented that
Health plans increasingly provide user-friendly online tools and clear materials to make sure that consumers understand the benefits and costs of their health insurance policies. The benefits of providing a new summary of coverage document must be balanced against the increased administrative burden and higher costs to consumers and employers. For example, since most large employers customize the benefit packages they provide to their employees, some health plans could be required to create tens of thousands of different versions of this new document—which would add administrative costs without meaningfully helping employees.  Moreover, given that the final regulation is delayed, the implementation date also should be pushed back to give health plans sufficient time to make the operational and administrative changes needed to create these new documents.  We will be submitting detailed comments and look forward to working with regulators to mitigate potential unintended consequences of this new requirement.
The Affordable Care Act required the ACA regulators to issue this template no later than March 23, 2011. Given the five month delay, the ACA regulators should give plans at least five months of extra time. The implementation timing for group health plans should align with the calendar year based open season -- fourth quarter 2012. Kaiser Health News reports that
Many employers are already required to provide health plan information, said Steve Wojik, vice president for public policy for the National Business Group on Health, which represents 330 large employers, most of which have self-insured health plans. Complying with the new health law rules would mean preparing two sets of plan information for next year. Pushing back the March 2012 deadline would avoid the duplicative effort, he said.

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