The Scan

A roundup of studies and developments related to health reform.

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February 9, 2012

HHS Issues Final Rule on Summary of Benefits and Coverage and Uniform Glossary

The Department of Health and Human Services’ Center for Consumer Information and Insurance Oversight (CCIIO) issues final regulations for the Summary of Benefits and Coverage (SBC) and Uniform Glossary. The SBC will detail, “in plain language, simple and consistent information about health plan benefits and coverage,” according to CCIIO. Both the SBC and the accompanying Uniform Glossary will be provided to consumers when “when shopping for coverage, enrolling in coverage, at each new plan year, and within seven business days of requesting a copy from their health insurance issuer or group health plan.” The SBC also includes coverage examples which will “illustrate how a health insurance policy or plan would cover care for common benefits scenarios. Using clear standards and guidelines provided by the Center for Consumer Information and Insurance Oversight (CCIIO), plans and issuers will simulate claims processing for each scenario so consumers can see an illustration of the coverage they get for their premium dollar under a plan.” Final versions of the SBC template and glossary are available.