New rules require plain-English summaries of health insurance plans

The Health and Human Services Department finalized rules Thursday that will require health insurance plans to provide a plain-English summary of what they cover.

Plans will have to give their customers a four-page summary of the benefits they offer. HHS said the information will help people make an “apples-to-apples” comparison as they shop for insurance and prevent insurers from using fine print to hide important information about what they will and won’t cover.

The final rules do not include certain changes for which consumer groups had lobbied, but HHS also will implement the requirements more quickly than insurers wanted.

Insurers wanted the rules to take effect 18 months after HHS finalized its regulations. Instead, the department gave them roughly six months.

Consumer advocates had said plans’ premiums should be noted on the summary of benefits. Although that’s not required under the healthcare law, consumers recently said “it is intuitively obvious that premium information greatly increases a consumer’s understanding of his or her options.”

HHS said Thursday that premiums don’t need to be a part of the coverage summary.

“Let’s be clear — people get premium information,” said Steve Larsen, the director of the HHS office that is implementing most of the healthcare law.

Benefit summaries will offer examples of how a plan would cover certain healthcare procedures — such as a pregnancy and managing diabetes. HHS previously considered using breast-cancer treatments as a third example, but axed it from the final rules. Larsen said there are simply too many variations from patient to patient in how breast cancer is treated.

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