So when I'm reading the bill and get stuck in the molasses, I'll throw it up in grey so you know that I was struggling on the paraphrasing. If you see something in grey, please help me out and post your thoughts on that section. I'll go back and edit yesterday's post with this too.
The Secretary has a year to create a standard summary of benefits. He will consult with the National Association of Insurance Commissioners to develop the standard. The standard will:
- follow the same 4-page format in 12 point font or larger,
- use language that the average customer can understand
- contain consistent definitions
- describe the coverage on the benefits from yesterday's post
- describe any other benefits the plan has
- describe any limitations the plan has
- describe the deductibles and copays
- say if and how the plan is renewable
- have examples of common scenarios like pregnancy and serious medical conditions
- state if the plan meets the minimum coverage requirement, and if it covers 60 percent of the costs of what the plan says is covered.
- state that the summary is a summary, and not the full coverage document
- a contact number for additional questions, and a website where the full coverage document can be found
Starting in 2 years, insurance providers need to provide these summaries: to anyone when they apply for a policy, to anyone when they enroll or re-enroll in a policy, anytime a policy gets issued, and at least 60 days before any changes to the policy go into effect.
The bill then defines what an insurance provider is. No suprises here so I won't paraphrase.
Every time an insurance provider doesn't provide a new summary when they're supposed to, they will have to pay a $1,000 fine.
The Secretary is responsible for coming up with standard insurance and medical terms. The bill lists 23 terms, and says The Secretary can add more.
Good place for a break. Still trying to make it to page 44 today, so stay tuned.