Rules aim to make health plans more understandable
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WASHINGTON --The Obama administration issued regulations Thursday requiring health plans to describe what they cover in clear, standardized language understandable to consumers.
The regulations are an attempt to implement one of the much-anticiapted consumer protections provisions in the new health care law President Barack Obama signed in March 2010.
Starting this fall, insurers and employers that offer health coverage must provide a six-page form that summarizes basic plan information, such as deductibles and co-pays, as well as costs for using in-network and out-of network medical services. The forms will also include estimated out-of-pocket costs for two basic examples of care -- delivering a baby and managing Type 2 diabetes.
The changes aim to allow consumers to assess how much their care would cost under different insurance policies, and to simplify the process of evaluating health plans -- a task that now can involve reviewing hundreds of pages published by insurers.
"One of the primary purposes of this is to ensure this apple-to-apples comparison across plans," said Steve Larsen, the senior Department of Health and Human Services official overseeing insurance regulation.
The simplified forms -- known as the Summary of Benefits and Coverage -- were mandated by the health care law.
Many consumer groups and patient advocates feared that the administration would back away from the requirement after insurers and employer groups complained that developing the forms would be costly and burdensome. The administration did put off the effective date until September, instead of March, and dropped a requirement that health plans include premiums on the forms.
First Published February 10, 2012 12:00 am
