This document contains proposed
regulations regarding disclosure of the summary of benefits and
coverage and the uniform glossary for group health plans and health
insurance coverage in the group and individual markets under the
Patient Protection and Affordable Care Act. This document
implements the disclosure requirements to help plans and
individuals better understand their health coverage, as well as
other coverage options. The templates and instructions to be used
in making these disclosures are being issued in a separate
notice.
The Patient Protection and
Affordable Care Act, Public Law 111-148, (the Affordable Care Act)
was enacted by President Obama on March 23, 2010. As part of the
Act, Congress added PHS Act section 22715 of the PHS Act directs
the Department of Health and Human Services (HHS), the Department
of Labor, and the Department of the Treasury (collectively, the
Departments), in consultation with the National Association of
Insurance Commissioners (NAIC) and a working group comprised of
stakeholders, to "develop standards for use by a group health plan
and a health insurance issuer in compiling and providing to
applicants, enrollees, and policyholders and certificate holders a
summary of benefits and coverage explanation that accurately
describes the benefits and coverage under the applicable plan or
coverage." Plans and issuers are required to begin providing the
required disclosure (herein referred to as a 'summary of benefits
and coverage' or 'SBC') no later than March 23, 2012. To implement
this provision, collection of information requirements will result
in an estimated burden increase of 649,500 hours and 79,699,998
estimated annual responses.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
Cost Estimates.pdf
Supporting Statement-.doc
REG-140038-10 - Summary of Benefits and Coverage and the Uniform Glossary