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Sept. 24, 2012
WASHINGTON, D.C. Insurers are now required to provide consumers with a summary — in plain English — of the coverage and costs in their health plans. The requirement is part of the 2010 health reform law sometimes referred to as "Obamacare."
Starting today, insurance companies are required to provide consumers with a Summary of Benefits and Coverage (SBC) along with a standardized glossary that defines insurance and medical terms in basic language.
Consumers can request a free SBC at any time, but it will also be made available when enrolling in or renewing coverage, and whenever information in the summary changes significantly.
Health and Human Services secretary Kathleen Sebelius said Americans will now get clear and comparable information when shopping for health coverage.
“These new tools empower consumers to make informed decisions about their health coverage options and to choose the plan that is best for them, their families, and their business,” Sebelius said.
The SBC includes a comparison tool — modeled on the Nutrition Facts label required for packaged food — intended to help consumers compare coverage options by showing a standardized sample of what each health plan will cover for two common medical situations: having a baby and managing type 2 diabetes.
The SBC will include information about the covered health benefits, out-of-pocket costs and the network of providers. The glossary defines terms commonly used in the health insurance market, such as “deductible” and “co-pay,” using clear language.
Before today, people often lacked uniform and comparable information when shopping for coverage, often relying only on insurance company marketing materials to make decisions.
The KHI News Service is an editorially independent initiative of the Kansas Health Institute and is committed to timely, objective and in-depth coverage of health issues and the policy making environment. Find more about the News Service at khi.org/newsservice or contact us at (785) 783-2529.