[lg policy] Insurance policy writers - watch your language from here on out

[Harold Schiffman]

Insurance policy writers - watch your language from here on out


By Ernie Shannon on February 9, 2012 - 8:28pm for eMaxHealth

    Affordable Health Insurance



The Obama Administration continues to implement in bits and pieces the
Affordable Care Act signed into law in March 2010 and planned for full
operation by 2014. The latest move by the Department of Health and
Human Services (HHS) is a requirement that health insurance companies
use plain language in describing in describing health plans and their
benefits.

In a noon-day press release, HHS Secretary Kathleen Sebilius said,
“All consumers, for the first time, will really be able to clearly
comprehend the sometimes confusing language insurance plans often use
in marketing. This will give them a new edge in deciding which plans
will best suit their needs and those of their families or employees.”

The new rules strike at the marketing materials insurers use to
advertise their plans and require companies to explain their benefits
in “concise and comprehensible” terms. The guidelines also demand
sufficient clarity to allow people to easily compare one plan with
another. Another expectation of the ruling involves two documents that
will be available for every American shopping for health insurance.
The first is what Sebilius called a short, easy to understand Summary
of Benefits and Coverage or SBC. The second is a uniform glossary of
terms commonly used in health insurance coverage such as deductible
and co-payment.
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The new explanations will take effect on or soon after September 23.

A SBC document will constitute a standardized plan comparison tool
called coverage examples similar to the Nutrition Facts label required
for packaged foods. The coverage examples will illustrate medical
situations and describe the coverage the plan provides of having a
baby, for example, or managing Type II diabetes. The examples will
help consumers understand and compare what they would have to pay
under each plan.

Today’s decision to finalize rules first proposed in August 2011
resulted from input from stakeholders such as the National Association
of Insurance Commissioners (NAIC) and a working group composed of
health insurance-related consumer and advocacy organizations, health
insurers, health care professionals, patent advocates, according to
Sebilius.

The NAIC is an organization of state insurance commissioners designed
to be a forum from which model laws and regulations are created for
use by states nationwide. The federal government has used the NAIC as
an adviser in the process of developing the Affordable Care Act and
although some of its advice appears in the law today, other provisions
have been hotly contested by the commissioners such as the medical
loss ratio. In this case, the NAIC apparently cooperated with the
government in assembling the rule on language and clarity of
insurance-related documents.

http://www.emaxhealth.com/11394/health-insurance-policy-writers-what-your-language-here-out

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