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.
