New Rules for Uniform Communications: More Health Care Reform Compliance

Get ready for new required required notices and definitions! Be prepared to update your communications to plan participants! Wednesday, the departments of Labor, Health and Human Services (together with the Treasury) gave us the new proposed rules for the "uniform summary of coverage" that is required under PPACA. Health insurers and group health plans have to provide consumers with clear, consistent and comparable information about their health plan benefits and coverage starting in 2012. All health plans and issuers would provide a summary of benefits and coverage, along with a uniform glossary of terms, to employees before enrollment. Health plans and issuers must also provide notice at least 60 days before any significant modification is made in the plan or coverage during the plan or policy year. You could insert a lot of fancy discussion here about what the purpose of the provision is but, in short, it is simply a dumbing down of the summary of benefits coverage into some simple standard boxes for comparison shopping. If the exchanges ever actually come into existence, this would allow an employee to compare employer sponsored coverage against other market-available options. For more details about the proposed regulations, check out the Model Summary of Coverage, the Fact Sheet requesting public comment and, of course, the proposed regulations. As these are merely proposed, there is nothing final and employers do not have to immediately act, nor can then act until the proposed uniform definitions are drafted. But employers and plan sponsors should keep this information handy as a reference point for developing a long-term compliance strategy.

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