Plain-language rules go into effect for health plans, HHS says

Insurance companies must now provide consumers in the individual health market a description of what their plans cover through a summary of benefits and coverage, HHS announced Monday.

Required under the Patient Protection and Affordable Care Act, the summary for consumers has information about covered health benefits, out-of-pocket costs and the network of providers. It also includes a comparison tool called “Coverage Examples” that is modeled after the nutrition-labeling feature for packaged food. Consumers can use it to compare options of what different health plans offer for two common medical conditions: managing Type 2 diabetes and having a baby.

In addition, consumers can also access a uniform glossary that defines insurance and medical terms. HHS developed both the summary and the glossary with the Labor and Treasury departments, consumer groups, state insurance commissioners, and other insurance industry representatives.

The summary—which consumers will receive in writing and free of charge from their insurance company or employer—is available now for those in the individual market and will be available for those enrollees in group health plans during open-enrollment periods that begin after Sept. 23.