Consumer Advocates, Organizations Push for Faster SBC Implementation

In a November 9 letter to the Deputy White House Chief Of Staff, Deputy Assistant to the President for Health Policy and Director of the National Economic Council, a number of American health care consumers, health care practitioners and consumer advocates urged a prompt, effective implementation of the Summary of Benefits and Coverage (SBC).

Under the Affordable Care Act, SBC requires health insurers and group health plans to provide consumers with a concise document detailing, in plain language, simple and consistent information about health plan benefits and coverage. This SBC document will help consumers better understand the coverage they have and, for the first time, allow them to easily compare different coverage options, according to the U.S. Department of Health & Human Services. It will summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions. Specifically, the proposed regulations would provide consumers with two forms that include: An easy to understand Summary of Benefits and Coverage, and an uniform glossary of terms commonly used in health insurance coverage such as "deductible" and "co-pay"

The letter, signed by organizations and individuals, including 11 people identified as consumer liaisons by the National Association of Insurance Commissioners, highlights dismay at the news that insurers and business groups that “have filed comments with the agencies asking that the implementation of the rule be delayed by almost two years and that it not be implemented at all with respect to the 170 million Americans insured through their jobs, in defiance of the express requirements of the law.”

In mid-August, America’s Health Insurance Plans Press Secretary Robert Zirkelbach released the following statement, highlighting increased administrative burden and higher costs to consumers and employees that a new summary of coverage document would cause. “Given that the final regulation is delayed, the implementation date also should be pushed back to give health plans sufficient time to make the operational and administrative changes needed to create these new documents,” Zirkelbach said.

The November 9 letter says “Full implementation of this [SBC] form is needed to protect individual health insurance purchasers but also to make our health insurance markets work better.” Read the full letter here.