Good News: Agencies Delay Summary of Benefits and Coverage Requirement

Legal Alert

October 11, 2012

Recently, new Frequently Asked Questions ("FAQs") were issued by the Departments of Labor, Treasury, and Health and Human Services (the "Agencies"). In the FAQs, the new "summary of benefits and coverage," including uniform glossary requirements, have been delayed until the Agencies issue final regulations. The FAQs specifically state that the final regulations will include "an applicability date that gives group health plans and health insurance issuers sufficient time to comply." As the proposed effective date for these requirements was March 23, 2012, these FAQs likely mean that, once the final regulations are issued, group health plans will have additional time to implement these requirements.

As a reminder, under the Patient Protection and Affordable Care Act ("PPACA"), group health plans and insurers are required to provide plan participants and beneficiaries with a summary of their benefits and coverage, including a uniform glossary of common health terms. Earlier this year, the Agencies issued proposed regulations on this requirement, which included templates for the summary and uniform glossary. Details regarding the proposed regulations addressing the new summary of benefits and coverage requirement are included in our previous SGR Client Alert.

According to the Agencies, many public comments were submitted regarding the proposed regulations and templates. As a result, the Agencies intend to issue final regulations as soon as possible. As stated in the FAQs, until final regulations are issued and applicable, plans and issuers are not required to provide summaries of benefits and coverage to plan participants and beneficiaries.

For more information, please contact your SGR Executive Compensation and Employee Benefits counsel.