BOSTON--After the Supreme Court’s historic upholding of the Affordable Care Act (ACA), U.S. employers are looking at the next set of milestone regulations and seeking the most efficient way to comply. A major requirement – just several months away – is the Summary of Benefits Coverage (SBC), required to be in effect for open enrollment periods beginning on or after September 23, 2012. HighRoads, the industry leader in employer health care compliance and benefits management, notes that employers must have SBCs in place not only for the plan an employee is enrolled in, but for all plans for which that employee is eligible.
SBCs are meant to benefit employees by creating “clear, understandable and straightforward information on what health plans will cover, what limitations or conditions will apply, and what they will pay for,” according to the U.S. Department of Health and Human Services.
“Under the SBC regulations, as an employee, I am entitled to an SBC for my enrolled plan but I must also be able to view the SBC for any plan I am eligible for. In corporations with multiple plans and many employees, it is an enormous logistical and communications challenge,” said Kim Buckey, principal, Compliance Communications Practice, HighRoads.
“The Supreme Court decision has given a measure of certainty to employers in planning for the future, and employers welcome this certainty,” said Tom Barker, partner in Foley Hoag. “That being said, employers have a tough road ahead, as public opinion polls continue to show a widespread lack of understanding over what the law means for most people. This means that employers will need to continue to communicate aggressively and clearly with employees over their options in the coming months.”
HighRoads has been an active participant in providing to U.S. Department of Health and Human Services officials data and industry insight on communications practices and technology used to implement SBCs. HighRoads survey on employers’ willingness to continue health benefits in light of reform was cited in the official Federal Register on SBC rules and regulations, February 14, 2012.
HighRoads is committed to delivering innovative and cost effective technology-enabled consulting for addressing the ACA and ERISA regulations. For over a decade, HighRoads has automated the benefits management and compliance process for hundreds of leading employers. In the next few weeks HighRoads recommends employers focus on these four key tasks when it comes to SBCs:
“Now is the time to begin work in earnest on SBCs, to finalize 2013 plan designs, and to prepare a communication strategy that encompasses not only this fall’s open enrollment but the impact of exchanges in 2014,” added Buckey.
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