Federal Government Mandates Changes for Health Care Summary of Benefits Coverages

It is rare to find an employee who completely understands his or her health care plan. Due to this, many employees choose a plan that does not satisfy their medical needs or their budget. A newly released Aflac survey of 2,200 U.S. workers revealed that 42% of employees waste money each year because they are enrolled in the wrong health care plan. 
 
With these concerns in mind, the Obama Administration is mandating a new template for The Summary of Benefits and Coverage (SBC). The change, which will take effect March 2012, will force employers and health insurers to give a clearer summary of benefits to participants in plain English. 
 
The new SBC may be no longer than four, double sided pages. Although the summary is shorter, it must be thorough. It must explain which expenses a health plan would cover for common health issues. 
 
Additionally, a glossary must be provided to employees which describes basic health care terms to help them understand the ins and outs of their health care plan. Finally, if the employer plans on modifying plans during the coverage year, they must notify their employees at least 60 days in advance. 
 
Disadvantages: The main disadvantages stem from preparations needed for these changes to take place for insurers and employers. Premiums may rise in order for insurers’ need to cover the administrative costs for preparing the new summaries. Additionally, employers will have to spend time answering employee questions about the changes and their consequences
 
Advantages: In the long run, employees will be better able to understand their health care plan and ask the right questions to make sure they are enrolled under the correct health plan. 

Get a Free Demo

Fill out the form below & we'll email you a video product demo!

Which solution are you interested in?
Optimum Solutions will not sell, rent, or lease your personal information.

Accounting Manager Betsy Heilman, Dimensions

Support has been excellent. Most companies have good software but are lacking in the support of that software once it is purchased. We have had good experiences with your support staff.