Back in August, we told you about how the Dept. of Health & Human Services was finalizing a template for new health insurance labels that would attempt to make it clear what a potential customer was buying and what sort of coverage they would receive.
Today HHS revealed the final format of the label. Above is what the first page of the 6-page template (see the whole PDF here). Subsequent pages cover costs and limitations for in- and out-of-network care for a variety of common expenses like doctor’s visits, prescriptions, tests, mental health, substance abuse treatment, prenatal care, dental or eye coverage.
“All consumers, for the first time, will really be able to clearly comprehend the sometimes confusing language insurance plans often use in marketing,” said HHS Secretary Kathleen Sebelius. “This will give them a new edge in deciding which plan will best suit their needs and those of their families or employees.”
Insurers are expected to begin using these labels in their marketing and sales materials starting around September 23, 2012.
“A driving force behind the Affordable Care Act was to make the health insurance market work for consumers,” said Lynn Quincy, senior policy analyst for Consumers union, the policy and advocacy division of Consumer Reports. “The new Summary of Benefits provides consumers with important insurance information in a standardized way for the first time. Our consumer testing showed that consumers dread purchasing insurance largely because they don’t understand it and current health plan documents are insufficient. This rule is a big step in helping consumers better understand and evaluate their insurance options.”
The labels all use a common glossary (PDF) so that insurers can not say “that’s not what we meant by ’emergency services.'”
Quincy adds, “By making the terms of health insurance plans easier to understand, consumers are less likely to find themselves in health plans that don’t meet their needs. We appreciate that HHS recognizes consumers would benefit from additional coverage examples.”