Agencies propose rules for uniform statements of benefits under PPACA

HRS Insight
The Patient Protection and Affordable Care Act (PPACA) amended the Public Health Service Act (PHSA) to require group health plans and health insurance issuers to provide a summary of benefits and coverage to applicants and enrollees. The law specified the size of the summary (no more than four pages in 12-point font), the language (culturally and linguistically appropriate) and the required content. At least 60 days prior to any change in the plan, a notice of modification must be provided. PPACA also requires that standard definitions of insurance-related terms and medical terms be developed for use in describing health insurance coverage. The Departments of Treasury, Labor and Health and Human Services (the "Departments") have released Proposed Regulations regarding disclosure of the summary of benefits and coverage and the uniform glossary of terms, and issued a proposed template and proposed uniform glossary to be used in satisfying these requirements.


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