Section 2715 of the PHS Act directs
the Department of Health and Human Services (HHS), the Department
of Labor (DOL), 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. To implement these disclosure requirements, collection of
information requests relate to the provision of the following:
Summary of benefits and coverage, which includes coverage examples.
A uniform glossary of health coverage and medical terms. Notice
of modifications.
In addition to the two existing
coverage examples, these proposed regulations would require a third
coverage example – a simple fracture (with emergency room visit).
In May 2012, the Departments announced the development of a
calculator that plans and issuers could use as a safe harbor for
the first year of applicability to complete the coverage examples
in a streamlined fashion. Given the complexity of the existing
coverage examples and the addition of a new, third coverage example
to the SBC requirements, the Departments are proposing that the
coverage example calculator be permitted for continued use.
$0
No
No
Yes
No
No
Uncollected
Chris Cosby 202
693-8540
No
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.
2715_SS 12-30-2014.doc
Modifications