Administration Making Health Insurance Benefits Easier to Understand

Consumers remain very confused about their health insurance coverage, but the federal government is looking to provide a better understanding of benefits for consumers shopping for coverage.

Consumers remain very confused about their health insurance coverage, but the federal government is looking to provide a better understanding of benefits for consumers shopping for coverage.

HHS and the Departments of Labor and Treasury are proposing rules that will make the Summary of Benefits and Coverage (SBC) more user-friendly, shorten and streamline the SBC, and improve the glossary to help consumers understand insurance terms.

“Our goal is to improve consumers’ access to concise and comparable health plan information to help them better understand their coverage options and make informed choices when shopping for a plan,” CMS Administrator Marilyn Tavenner said in a statement. “We listened to feedback from consumers and other stakeholders to improve and help streamline the information provided to consumers.”

Coverage examples in the SBC that demonstrate how the plan’s deductibles and other cost-sharing apply in 2 different scenarios have been proven to be the most useful feature, according to consumer testing.

The departments are also looking to significantly streamline and shorten the form by removing any information that is not required by statute. Through consumer testing, the departments are also removing information considered to be less relevant for people purchasing health insurance. As a result, the sample SBC for a typical group health plan is now 2-and-a-half pages, down from the 4 complete double-sided pages.

Consumers aren’t the only ones who will benefit from the changes, though. According to CMS, the revised SBC will also help employers when comparing plan options for their businesses and their employees. The proposed rule would clarify and streamline requirements health insurers and group health plans follow.

“These proposed regulations are designed to improve consumers’ access to important plan information so that they can make informed choices when shopping for and renewing coverage, as well as to provide clarifications that will make it easier for health insurance issuers and group health plans to comply with providing this information,” according to the proposed rule.