Summary of Benefits and Coverage further delayed

Summary of Benefits and Coverage further delayed

The Department of Labor released an addendum to its original FAQs page for the Affordable Care Act Implementation. Dated March 30, the new FAQs state the DOL will further delay the Summary of Benefits and Coverage template and all related documents until 2016. Employers and human resources professionals need to pay close attention to the newly proposed dates of implementation to maintain compliance with the ACA and SBC regulations.

What were the original regulations?

In December 2014, the DOL, the Department of Health and Human Services and the Department of Treasury released an FAQ outlining the proposed regulations for all impending changes to the SBC. As Cigna stated, these rules:

  • Dictated when and how employers or insurers are supposed to provide SBCs
  • Streamlined the SBC template, eliminating many questions
  • Edited the SBC glossary
  • Added a more universal cost example

After accepting comments on these proposed changes through March 2, these new regulations were to take effect on September 1. However, these dates have now been pushed back to allow for additional changes being made to the SBC.

What changed?

As of March 30, the departments in charge of the ACA and the SBC announced they are delaying the application date for some of the proposed changes to 2016. In addition, the original changes announced in 2014 underwent several updates, including, additional edits to the glossary, new claims and pricing data to help calculate coverage price, no more annual limits for essential health benefits information, a more universal cost example, new data on minimum essential coverage and minimum value information and a website for the policy or group certificate of coverage.

It's also possible there will be further changes made down the line; these are simply the current alterations under consideration. Should these amendments be accepted, the SBC documents will become finalized on Jan. 1, 2016, which means the regulations wouldn't technically go into effect until Jan. 1, 2017, when programs take effect for those enrolling in the fall of 2016.

What did not change?

There are, however, several stipulations originally proposed late last year that will still take effect on the previously anticipated date. The following stipulations will become effective Sept. 1, 2015 for any plan that begins Jan.1, 2016:

  • SBCs provided at enrollment and re-enrollment
  • Roles of participants responsible for tracking compliance when working with third parties
  • Health reimbursement accounts and health savings accounts applicability
  • Excepted benefits
  • Expatriate coverage
  • Medicare Advantage plans

Why the delay?

There are several reasons the departments decided to delay the implementation of some of the proposed SBC changes. One reason is businesses employing large numbers of people and insurers offering coverage expressed a need for more time to prepare documents for open enrollment this fall. Employee Benefit News reported the original start date didn't give employers and insurers enough time to change processes and carry out SBC deliveries adequately. The departments also would like to put some of the proposed amendments through consumer testing before implementation.

As evidenced by past changes made to guidelines like the SBC, input from consumers and businesses is critical to finalization. The National Association of Insurance Commissioners and other similar groups now have more time to offer insight, input and suggestions for the departments.

What does this mean for employers today?

While it may seem large and small businesses and their insurance providers have been given the gift of time, that is only partially true. Again, there are still changes that will go into effect Sept. 1, 2015. Plus, regardless of whether employers want to begin switching internal process now or later, Business Insurance noted eventually all parties will have to become compliant with these new regulations down the road. It's a good idea to start now, even if the final rules haven't been announced just yet.

This is true especially for businesses offering multiple benefits packages. Big corporations with a multitude of benefit options for employees will need to start now to keep up with the changes over the next few years. Each package will require a different statement, and it can't hurt to get ahead by making amendments to the statements now in anticipation of regulation completion later. This is where employee management software can become incredibly useful. HR is burdened with communicating this essential, albeit confusing, information to all employees. With a comprehensive platform that offers support and organization, navigating the rocky waters of SBC changes becomes infinitely more manageable.

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