“Summary of Benefits and Coverage” brings clarity to health plan

Posted on Feb 13, 2012 in Government, Healthcare, Plain Language Blog Articles

At last, consumers will have a “Summary of Benefits and Coverage” as a standardized, plain language tool to understand their health plans. Under a rule announced last week by HHS, health insurers are now required to provide consumers with clear, consistent, and comparable summary information.  Here’s the link:


Testing by Consumers’ Union showed that consumers could use the standardized health information, but the two scenarios about having a baby and treating Type 2 diabetes gave them a better sense of what was covered and the value of health insurance. These scenarios, formatted much like the Nutrition Facts label with plain language a key component, show consumers what proportion of the cost of care a health insurance policy or plan would cover and will help consumers compare across health plans they are considering. One test participant talked about the scenarios as “putting furniture in an empty house” so she could see how she would “live” in the policy.

“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.”

The new explanations, which will be available beginning, or soon after, September 23, 2012, will be a critical resource for the roughly 150 million Americans with private health insurance today.

Stakeholders as the National Association of Insurance Commissioners (NAIC) and a working group composed of health insurance-related consumer advocacy organizations, health insurers, health care professionals, patient advocates including those representing people with limited English proficiency, and others helped to develop the Summary and scenarios. The Center for Plain Language wrote a letter to OMB to support the approval of this important plain language document.

Let us know how you like the Summary!