Skip to content

Health Insurers Seek Delay Of New Consumer-Friendly Coverage Forms

Shopping for health insurance next year will be easier when hundreds of health insurers and employers use the same simple forms unveiled Wednesday by the Obama administration, consumer advocates and government officials say.

But the new materials, required by the 2010 health law, are still a work in progress. The public will have 60 days to comment on any changes that may be needed in the 132 pages of rules for the forms, federal health and labor officials said.

Officials will even consider bending the law’s March deadline for distributing the forms, which are intended to explain benefits and costs in easy-to-understand terms so that consumers can comparison shop for the best coverage. The materials include a benefits summary chart, definitions of commonly used terms, and two pages of coverage facts labels – modeled after the nutrition facts labels on prepared foods – that show how much a plan pays for the average national cost of three common medical conditions. The law prohibits “fine print,” requiring materials to be printed in at least 12-point type (larger than the type in a typical newspaper article).

“Many times people will make decisions on coverage and not understand what it means for them until they get sick or until their care is denied or until they face high out of pocket costs,” Don Berwick, administrator of the U. S. Centers for Medicare and Medicaid Services, said Wednesday.

Dan Maguire, director of the Department of Labor’s Office of Health Plan Standards and Compliance Assistance, asked for comments on whether the forms should be modified for self-funded employer plans and whether use of the forms could be phased in over time.

Health and labor officials also want feedback on whether the forms should be limited to four single- or double-sided pages — a detail the law apparently omits.

The law requires that all insurers and employers offering health coverage provide the forms to more than 160 million beneficiaries and upon request to new applicants either electronically – by email or on the Internet – or on paper, by March 23, 2012. In some cases, forms for individual policies would be available only on the Internet. The forms were drafted by a group assembled by the National Association of Insurance Commissioners that included state insurance regulators, and insurance, consumer and patient advocacy representatives.

Many employers are already required to provide health plan information, said Steve Wojik, vice president for public policy for the National Business Group on Health, which represents 330 large employers, most of which have self-insured health plans. Complying with the new health law rules would mean preparing two sets of plan information for next year. Pushing back the March 2012 deadline would avoid the duplicative effort, he said.

Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, a trade group, also called for a delay because the federal agencies were four months late in issuing the rules. He said health plans need more time “to make the operational and administrative changes needed to create these new documents.”

“There is room for improvement,” said Lynn Quincy, senior policy analyst at Consumers Union, which tested some early drafts with consumers. She said the revised forms have not been consumer tested, and translations of the forms were never tested with non-English language speakers.

Related Topics

Insurance The Health Law