The departments of Labor, Health and Human Services, and Treasury issued a set of 14 frequently asked questions (FAQs) and answers regarding implementation of the summary of benefits and coverage (SBC) provisions of the Affordable Care Act (ACA). Importantly in the FAQs, the departments announced that they would not take enforcement action against insurers in a number of circumstances for failure to fully comply with requirements that they provide a standardized SBC during the first year of applicability of the new rules. The departments issued a final rule in February requiring insurers to use plain language in describing benefits and coverage. With the final rule, the departments released a uniform glossary of terms. The guidance is the ninth set of FAQs posted regarding ACA compliance. This set of FAQs also addresses when plans and issuers can provide SBC electronically, circumstances that will trigger the requirement for an issuer to provide an SBC, and whether issuers are required to provide SBCs to group health plans or their sponsors that are shopping for coverage but have yet to submit an application.

Today the Department of Health and Human Services, the Department of Treasury, and the Department of Labor released a final rule requiring insurers to use plain language in describing health plan benefits and coverage under the Affordable Care Act (ACA). The regulations mandate health insurers and group health plans to provide concise and comprehensible information about health plan benefits and coverage to Americans with private health coverage. The new rules will also facilitate easier plan comparison for individuals and employers. The new explanations, available on or soon after September 23, 2012, will be a critical resource for the roughly 150 million Americans with private health insurance. Specifically, these rules will ensure consumers have access to two key documents that will help them understand and evaluate their health insurance choices...