IRS Issues Benefits Summary Rule; Insurers Must Offer Consumer Details

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The Internal Revenue Service, the Employee Benefits Security Administration, and the Centers for Medicare and Medicaid Services release proposed rules (REG-140038-10) that would require insurers to make available to consumers a standardized summary of the benefits and coverage for each plan they offer. The goal is to increase transparency in the insurance market so that consumers can compare plans on an apples-to-apples basis and make an informed choice about which to purchase. Insurers and group health plans will be required to provide the information. The standard summary, which can be no more than four double-sided pages, would have to include information about the policy a consumer is considering, such as its premium and deductible costs, covered benefits, and coverage limitations and exceptions. Under the proposed rules, health insurance issuers and group health plans would be required to provide either online or in print the summary and the glossary to consumers before they purchase or enroll in a plan, including before a plan is reissued or renewed.

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