Health Insurance Benefits Will Now Be More Easily Compared

Health Insurance Benefits Will Now Be More Easily Compared image

On December 22, 2014 the Departments of Health and Human Services, Labor, and the Treasury announced a proposal of a new rule that would streamline the health insurance benefits offered on health exchanges and through employers. This rule would require a standardized summary outlining which health insurance benefits are covered by a particular plan and is meant to allow for easier comparisons by consumers purchasing insurance.

Currently, the Summary of Benefits and Coverage (SBC) available is not standardized. New rules would add to the SBC a more clear outline of not only services and health insurance benefits covered but costs to consumers. According to the CMS press release,

“The proposed rules would also significantly streamline and shorten the Summary of Benefits and Coverage as demonstrated by the sample completed Summary of Benefits and Coverage that has been reduced from 4 double-sided pages to two and a half.  Improvements have also been made to a Uniform Glossary that helps consumers understand insurance terms.”

Newly proposed rules were developed in response to feedback collected from consumers and others in the industry to provide the most relevant and clear information to those comparing health insurance benefits.

As a healthcare provider, these changes will have little effect on the day to day workings of a medical office. However, by ensuring this information is made as clear as possible, the Departments of Health and Human Services, Labor, and the Treasury’s proposed rule should lead to more well-informed consumers. As consumers become better informed regarding their own health insurance benefits and acquire a better understanding of the out of pocket costs and copays incurred after a visit to a medical office, this should help to alleviate confusion regarding billing after a visit.

To see an example of the new SBC layout and how the health insurance benefits will stack up, click here. You may also review a fact sheet overviewing the proposed Summary of Benefits and Coverage from the CMS.

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