HHS Officials To Unveil Standard Form Detailing Health Plan Information
On Wednesday, CMS Administrator Donald Berwick and other HHS officials are expected to unveil a proposed new standard form to provide consumers with details of each available health insurance policy, the Wall Street Journal reports.
The new form is expected to be similar to one developed by the National Association of Insurance Commissioners and has been likened to standard food-nutrition labels.
Consumers often are able to access the details of health plans -- usually in the form of a document called the certificate of coverage or evidence of coverage -- only after enrolling in a health plan.
A McKinsey survey conducted in 2010 and 2011 of 11,000 consumersÂ younger thanÂ age 65 found that 72% of respondents think health plans are difficult to understand. Fifty-seven percent said they found the process of choosing a plan overwhelming.
Proposed New Form
The six-page proposed standard form would feature "clear, easy-to-read and concise information that tells [consumers] what they need to know," according to Erin Shields, an HHS spokesperson. The form would include details about:
- Deductibles for specific categories;
- Out-of-pocket spending limits and what expenses do not count toward the limit; and
- Consumer costs for specific medical events and associated services, as well as for three common situations: labor and delivery, breast cancer treatment and diabetes management.
Consumers would be able to access the form before purchasing a plan. In addition, employers would be required to supply the plan summary to new hires and all employees during open enrollment periods.
Reactions to New Form
Amir Mostafaie, director of quality and training at eHealth Inc., said the new form would be a "big deal to consumers, because they will have a standard way of receiving information."
Some insurers voiced concern over the potential cost and administrative burden of the new requirement. A spokesperson for America's Health Insurance Plans noted that some plans would be forced to provide "tens of thousands of versions of this document."
HHS will finalize the form after an open comment period, and the requirement to provide the form will take effect in March 2012 (Wilde Mathews/Adamy, Wall Street Journal, 8/17).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.