SBC Final Rule & Obama Compromises on Contraceptives

Feb 23

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2/23/2012 8:58 AM  RssIcon

It’s been a busy week!

The Departments of Labor and Health and Human Services, along with Treasury/IRS, released a final rule on the health care reform requirement that group health plans provide a summary of benefits and coverage (SBC) to consumers.

Originally slated for March 23, 2012, the final rule requires plans with plan years that start September 23, 2012 or later to supply SBCs in their next open enrollment. Other changes from the proposed rule include:

· allowing the SBC to be incorporated into the Summary Plan Description (SPD) if the SBC information is intact and prominently displayed at the beginning of the SPD;

· permitting reasonable attempts to comply with the 4 page, double-sided, page limit;

· reducing the number of coverage examples from three to two (normal delivery childbirth and Type 2 diabetes);

· recognizing that if a plan’s terms cannot be reasonable described using the template, the plan or insurer’s best efforts to comply with the template is permissible;

· switching out terms like “policy” and “insurer” and using “coverage” and “plan” instead; and eliminating premiums from the required contents.

NOTE: Employee Benefits Corporation is closely reviewing the final rule. We are dedicated to ensuring that your Health Care FSA and EBC HRA remain compliant.

For more information on SBC, visit: http://www.hhs.gov/news/press/2012pres/02/20120209a.html

Also, in an attempt to calm the storm surrounding the requirement that non-profit religious organizations provide access to contraceptives for their employees through their insurance plan without co-pays, deductibles or co-insurance (churches are exempt), President Obama announced a new game plan.

If a non-profit religious organization objects to the rule, insurance companies will be required to reach out to employees and offer the coverage directly. Obama felt this compromise still fulfills the core goal of the rule – that all women, no matter where they work, have access to free preventative care (including contraceptives).

 

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