Plain-language regulations issued for health plans…An important factor for all of us.

Final rules issued by the Obama administration established the first nationally standardized descriptions for the coverage provided by health insurance plans.

The regulations require plans issued after Sept. 22, 2011 to provide consumers with a summary of their benefits and coverage, as well as a glossary defining the terms used in the description.

“Markets work best when people have the information they need to make informed decisions,” Marilyn Tavenner, acting administrator of the CMS, said in a call with reporters.

The disclosure requirements, mandated by the Patient Protection and Affordable Care Act, aim to simplify consumer comparisons of various insurance plans, which have used marketing materials to sometimes obfuscate their details, according to HHS officials.

The new rules, published jointly by HHS and the Labor and Treasury departments, also require each plan to illustrate its costs of coverage in the cases of childbirth and treatment for diabetes.

The final rules dropped a requirement in an earlier draft that plans also specify the likely costs for its enrollees receiving treatment for breast cancer. That required example was dropped, according to Steve Larsen, director of the Center for Consumer Information and Insurance Oversight at CMS, because of concerns that breast cancer treatment is more complex and less-standardized than care for routine births and diabetes.

The final rules also specified that those examples were not meant to provide the exact price for such cases.

“This is meant to be a vehicle to compare how different conditions and treatment scenarios would fare under different health plans and not necessarily ‘Here’s a prediction of what exactly you would pay if you had this condition,’” Larsen said in the same press call.

Another provision dropped in the final rule is an absolute mandate that insurers provide all of the required information in only four pages. The final rule will allow them to enlarge the disclosure beyond four pages if they make a good faith effort to first meet that size limit, Larsen said.

Well my friends, what do you think?? This is all going to make sense someday, but in the meantime, let me know in a word or two what you think about today’s post. Thank you for visiting!! 🙂

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