Insurers Required to use Plain Language for Coverage Description

Feb. 9, 2012
According to final regulations for the Affordable Care Act, those in the market for health insurance will soon have clear, understandable and straightforward information on what health plans will cover, what limitations or conditions will apply, and what they will pay for services. The new rules were published by both the Departments of Health and Human Services (HHS) and the Labor and Treasury.

According to final regulations for the Affordable Care Act, those in the market for health insurance will soon have clear, understandable and straightforward information on what health plans will cover, what limitations or conditions will apply, and what they will pay for services.

The new rules were published by both the Departments of Health and Human Services (HHS) and the Labor and Treasury. They require health insurers to eliminate technical or confusing language from their marketing material. According to HHS, this confusing jargon can make it confusing for consumers to understand exactly what they are buying.

“Consumers, for the first time, will really be able to clearly comprehend the sometimes confusing language insurance plans often use in marketing. This will give them a new edge in deciding which plan will best suit their needs and those of their families or employees,” HHS Secretary Kathleen Sebelius said in a statement.

In a similar vein, the idea of health literacy has been making industry rounds lately, in order to combat confusing medical terminology. For health literacy, there has been the National National Action Plan to Improve Health Literacy, which is a government sponsored plan. It’s clear the federal government has made this area a necessity.

Under the rule announced today, health insurers must provide consumers with clear, consistent and comparable summary information about their health plan benefits and coverage.  It will require insurers to create:

  •  A short, easy-to-understand Summary of Benefits and Coverage ( or “SBC”); and
  •  A uniform glossary of terms commonly used in health insurance coverage, such as “deductible” and “co-payment.”

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