Health Care Reform: Summary of Benefits and Coverage

With President Barack Obama winning re-election last month, the health care reform law is here to stay. Implementation of this law will continue over the coming months and years, and AssuredPartners NL will use this blog to update the changes that may affect how you or your business operates. Today, we review the changes to the summary of benefits and coverage, or SBC.

As noted in our latest compliance observer, health plans and issuers are required to provide an SBC to provide information about benefits and coverage in plain language to participants and beneficiaries. For those that enroll or re-enroll during an open enrollment period, the deadline to provide the SBC is the first open enrollment period that begins on or after September 23, 2012. For many companies who have open enrollment just prior to the change of the calendar year, now is the time to ensure compliance with these changes.

Additionally, if a health plan is going to be modified, the issuer must provide 60 days advance notice to the participant. This notice could be provided as an updated SBC or a separate summary of material modifications.  The 60 days requirement is effective as of September 23, 2012 as well.

For more information on these changes, please read AssuredPartners NL’ compliance observer or contact your AssuredPartners NL representative today. We are happy to help in this time of vast changes to the health care landscape.

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