An example of an insurance coverage label released by HHS. (Kaiser Health News)
It’s a fact: shopping around for health insurance plans is a challenge — even for the most health-savvy consumer. If you’ve ever read a health insurance plan’s “explanation” of benefits and finished feeling as though nothing was actually explained, you’re not alone.
Fortunately, that’s going to change. Last week, HHS unveiled an additional requirement for health insurance companies under the Affordable Care Act: plain language. Specifically, insurance companies will have to provide summaries that clearly explain their health plans — along with a glossary of commonly used terms.
In our opinion, this change couldn’t come fast enough. Starting in September, health insurance companies will be required to provide two new plain language forms. Both individuals and companies that offer health insurance to their employees will get these forms, the Summary of Benefits and Coverage (SBC) and list of definitions (“Uniform Glossary”). The new forms are based on prototypes that went through two rounds of testing for usability. What’s even better is that the forms were created in a public process that involved not only the National Association of Insurance Commissioners, but also a group of representatives from consumer advocacy organizations, health insurers, and patient advocates.
One of the most exciting features of the new forms is that commonly used insurance terms are printed in another color, and the Uniform Glossary defines them. Consumers, particularly those with limited literacy skills and limited English proficiency, can easily find out what words like “deductible” and “network” mean in each case. Another great feature is the “coverage examples” section, which looks a lot like the nutrition labels on packaged foods. Each coverage example takes a different situation (like having a baby) and breaks down what insurance will cover and what the patient will pay out of pocket. These coverage examples will go a long way toward showing consumers the difference between different plans.
At CommunicateHealth, we are optimistic. So is HHS Secretary Kathleen Sebelius, who had this to say on Friday: “All 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.”
What do you think of the new forms?
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