Amended by section 10101 of the Manager’s Amendment. By March 23, 2011, requires HHS to develop standards for use by plans offering group or individual health insurance coverage in compiling and providing to applicants and enrollees a summary of benefits and coverage explanation.
Requires HHS to consult with the NAIC and a multi-stakeholder working group as well as adhere to standards such as using terminology understandable by the average plan enrollee and providing a description of the coverage – including cost sharing for each of the essential health benefits categories – for illustrative common benefits scenarios.
Requires issuers to provide the summary at specified times within 2 years of enactment. Applies to health insurance issuers, including group health plans, as well as plan sponsors or administrators of self-insured plans.