Employers Catch a Break on Updated Benefit Summaries

March 29, 2016

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Source: Business Insurance

Employers will have plenty of time to comply with upcoming regulatory changes to the annual summary of health care benefits and coverages they must distribute to employees, according to a U.S. Department of Labor notice.

In a notice issued last week, the Labor Department said the new SBCs will not have to be distributed until the first day of the first plan year that begins on or after April 1, 2017.

Since most employers have plan years that begin on the first day of the year, that will mean, as a practical matter, that employers will have until Jan. 1, 2018, to distribute the new SBCs.

That will give employers and their plan administrators plenty of time to make adjustments to their current SBCs, experts say.

“There shouldn’t be any scrambling for employers to make any needed changes after final rules are issued,” said Steve Wojcik, vice president of public policy at the National Business Group on Health in Washington.

“There now is plenty of time to do it. The delay in the effective date is great news for employers with calendar-year plans because it provides an extra year to come into compliance,” added Rich Stover, a principal with Xerox HR Services in Secaucus, New Jersey.

The Labor Department has not yet issued final rules. Regulators set a March 28 deadline for comments on SBC rules it proposed earlier.

Like current rules, the proposed summary of benefits coverage statement would have to give examples of how coverage applies in two specific situations: having a baby and managing Type 2 diabetes.

In a change from current rules, employers also would have to detail how coverage applies in a third situation: simple fractures.

All the examples would have to provide sample costs of treatment.

There would be no change in current rules under which employers do not have to provide employees with paper summaries for every plan in which new employees are eligible to enroll. Instead, employers can provide a website on which to view them.

For employees already enrolled in a health plan, employers would have to provide an online SBC only for the plan in which the employee is covered, with electronic links to other available plans.

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