New Standardized Insurance Forms Could Make Buying Easier

Obama administration officials proposed rules Wednesday for simple, standardized information forms health insurers and employers will be required to use beginning next year.

The forms are intended to describe benefits and costs in the same easy-to-understand terms so that consumers can comparison shop for the best coverage. The materials will include a four-page benefits summary, a list of commonly used terms, and two pages of coverage fact labels – modeled after the nutrition labels on prepared foods – that show how much a plan pays for the average national cost of some common medical conditions. The federal health law says the materials must be printed in at least 12-point type, larger than the type in a typical newspaper article.

“Right now, it’s the Wild West — different states and different carriers have different definitions for the same terms,” said Sabrina Corlette, a research professor at Georgetown University’s Health Policy Institute and a member of a working group created by the National Association of Insurance Commissioners, which the health law designated to draft the materials. The group of nearly four dozen members includes state insurance regulators, and representatives of health insurers, consumer and patient advocacy groups.

They held more than 25 meetings and conference calls to develop a benefits summary chart and glossary, striving to turn baffling insurance jargon into plain English.

The chart and glossary were then tested with consumers last fall by Consumers Union and America’s Health Insurance Plans, a trade association. In July, the insurance commissioners approved the materials and sent them to the Departments of Health and Human Services and Labor, which were supposed to issue the rules four months ago.

Categories: Cost and Quality, Insurance