Friday, August 24, 2012

Summary of Benefits and Coverage


With health care reform being upheld by the Supreme Court Justices, there will be numerous new health care regulations that will be established over the coming years.  One particular regulation that will be required for all health insurance carriers is to provide employers with a Summary of Benefits and Coverage.  Health insurance carriers will be responsible to distribute these documents to each employer who offers a health insurance plan.  This regulation will take effect on September 23, 2012 for all health insurance plans that will be renewing on or after this date.

This Summary of Benefits and Coverage document will explain each provision of the plan in detail and the plan costs associated with each service.  The document will also highlight any procedures that may not be covered under the plan.  The reason for this summary is to inform all employees and participants of the plan about the services and plan costs associated with the health insurance plan.  It will also highlight any plan changes that may have taken place during the plan policy year.  It is up to the employer to distribute these documents to the employees once they have received them from the insurance carrier.

The Summary of Benefits and Coverage will be distributed either through e-mail to the plan administrator or via direct mail.  The health insurance carriers will be distributing these documents within a reasonable amount of time before the health insurance plan renews.  If the employer decides to switch health insurance plan designs, the health insurance carrier will provide an updated summary once the change has been processed.  To get employees started on understanding their health plan, we have included a link that will bring you to a sample glossary of terms document. (http://cciio.cms.gov/resources/files/Files2/02102012/uniform-glossary-final.pdf).  For more information about the Summary of Benefits and Coverage please contact our office at (978)-777-6554.

Thank You.