New rules for health plans require clear summaries of benefits - Los Angeles Times

New rules for health plans require clear summaries of benefits - Los Angeles Times:

Moving to implement a much-anticipated consumer protection in the new healthcare law, the Obama administration issued regulations Thursday requiring health plans to describe what they cover in clear, standardized language that is understandable to consumers.

Starting this fall, insurers and employers that offer health coverage will have to provide a six-page form that summarizes basic plan information, such as deductibles and co-pays, as well as costs for using in-network and out-of-network medical services.

The forms will also include estimated out-of-pocket costs for two basic examples of care: delivering a baby and managing Type 2 diabetes.
The changes are designed to allow consumers to assess how much their care would cost under different insurance policies, and to simplify the process of evaluating health plans, a task that now can involve reviewing hundreds of pages published by insurers.
"One of the primary purposes of this is to ensure this apples-to-apples comparison across plans," said Steve Larsen, the senior Department of Health and Human Services official overseeing insurance regulation.
The simplified forms, known as the summary of benefits and coverage, were mandated by the healthcare law signed by President Obama in March 2010.
Many consumer groups and patient advocates feared that the administration would back away from the requirement after insurers and employer groups complained that developing the forms would be costly and burdensome.

Found this via a post from Wendell Potter at Huffington Post. He notes that some advocates are calling for an illustrative case of cancer in the examples as well. I agree, as this can be among the most devastating events to a family, in every way including financially.

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