Posts Tagged ‘Summary of Benefits and Coverage’

DOL Issues FAQs For Summary of Benefits & Coverage

March 19, 2012

Today the Department of Labor added several new FAQs to its website regarding the implementation of the Summary of Benefits & Coverage requirements.    The FAQs can be accessed at http://www.dol.gov/ebsa/faqs/faq-aca8.html  Employers sponsoring group health plans must start complying with the requirements on the first day of their plan’s first open enrollment period on or after September 23, 2012.

Summary of Final SBC Rules

February 17, 2012

On Tuesday, the final Summary of Benefits and Coverage rules were posted in the Federal Register.  Employers sponsoring group health plans will have to comply with these rules starting with their first open enrollment period on or after September 23, 2012.  A summary of the final rules is available on the Davis Brown website.

Final Rules Released for Summary of Benefits & Coverage

February 9, 2012

Today the Department of Labor released final regulations implementing the Affordable Care Act’s summary of benefits and coverage (“SBC”) requirement.  The rules require  employers sponsoring group health plans to distribute an SBC to employees and participants in certain situations, such as at open enrollment.  The rules were originally supposed to be effective on March 23, 2012; however, the final rules delay the effective date.  The new effective date is (i)  the first day of the plan’s open enrollment period on or after September 23, 2012 for disclosures required to be provided to re-enrollees or late enrollees; and (ii) the first day of the plan year that begins on or after September 23, 2012 for individuals newly eligible for coverage (such as new hires or special enrollees).  For example, a calendar year plan with an open enrollment period beginning November 15 would need to begin complying with the new regulations on November 15, 2012 for re-enrollees and  late enrollees and January 1, 2013 for newly eligible individuals. 

We will provide a detailed summary of the new rules in the coming days.  A copy of the rules and additional DOL guidance can be accessed at http://www.dol.gov/ebsa/

SBC Requirements Likely to Be Postponed

November 18, 2011

The Affordable Care Act requires health insurers and employers sponsoring group health plans to implement a new summary of benefits and coverage notice by March 23, 2012.   Proposed rules implementing the new requirement were issued in August.   Over the last three months employers and insurers have questioned whether it is reasonable to expect compliance with the requirements by March 23, 2012 given final rules have yet to be issued.  Yesterday, the Department of Labor clarified in an FAQ that it does not expect employers or insurers to begin implementing the requirements until final rules are published.  The Department of Labor went on to say that regulators intend to give employers and insurers sufficient time after issuing the final rules to be in compliance.   Given the final rules have yet to be issued, it is likely the compliance date will now be sometime after March 23, 2012. 

A copy of the FAQ can be accessed at http://www.dol.gov/ebsa/faqs/faq-aca7.html

Feds Issue Summary of Benefits and Material Modification Rules

August 18, 2011

 Yesterday the DOL, HHS, and IRS released proposed rules implementing the Affordable Care Act’s requirement that group health plans and insurance issuers provide participants and beneficiaries with a written summary of benefits and coverage (“SBC”).   These rules also discuss a group health plan or issuer’s obligation to notify participants 60 days in advance of any material modifications to the health plan as outlined in the SBC.  Of particular note for employers is the clarification that the 60 day material modification notice will not apply to changes made in connection with an employer’s health insurance renewal, relieving fears that employers would need to change the timing of their insurance renewal processes and open enrollment periods.   Failure to provide an SBC or material modification notice when required results in a fine of $1,000.00 for each participant and beneficiary who failed to receive the SBC.  While these rules are in proposed format, we expect the rules to be finalized prior to their March 23, 2012 effective date.   For more information on the proposed rules, see our in-depth analysis at http://davisbrownlaw.com/news/legalissues/view/index.cfm/08_18_2011_summary_of_coverage__material_modification_rules_released .  Copies of the proposed SBC templates are available at http://www.healthcare.gov/news/factsheets/labels08172011b.pdf


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