<nobr>Oct 21, 2011</nobr>
ERIC Urges Proposals to Make Benefit Summaries Relevant to Self-Insured Plans
ERIC News Release
For Immediate Release: October 21, 2011
Washington, D.C. -- The ERISA Industry Committee (ERIC) today submitted comments on proposed regulations regarding implementation of the uniform summary of benefits and coverage (SBC) provisions under the Patient Protection and Affordable Care Act (ACA). The Departments of Health and Human Services, Labor, and Treasury published the proposed regulations in the Federal Register on August 22, 2011.
ERIC's letter warns that the proposed regulations, if not altered, have the potential to upend the manner in which information about a group health plan's coverage and benefits is provided to employees and beneficiaries.
"ERIC's members are deeply concerned that the proposed regulations will force them to provide benefit summaries that will frustrate, confuse, and even mislead their employees. The proposed SBC template is designed for insured plans in the individual and small group markets: it is poorly suited to communicate the essential terms of the group health plans offered by large employers," said ERIC President Mark Ugoretz.
In fact, ERIC's members believe that most self-insured plans already provide required benefits statements and should not be subject to the SBC requirements at all. The letter explains that employer group health plans are subject to detailed disclosure rules that already require them to provide much of the same information in summary plan descriptions, summaries of material modification, COBRA continuation coverage notices, and similar documents.
ERIC Vice President Gretchen Young added that, "if the government believes that self-insured plans must prepare these summaries, then the Departments should at least recognize they should implement the SBC requirement in a way that minimizes the duplicative and misleading information employers are forced to provide to their employees, and that makes the administrative burdens and expenses associated with the SBC as light as possible."
Thus, one of ERIC's principal recommendations is that the regulations should permit employers to adapt their existing communications to satisfy the SBC requirement rather than force them into a "one-size-fits-all template." The Departments should instead provide standards for the length, content, and format of the SBC, and should allow employers to design their own SBCs that meet these standards.
ERIC also recommends that the final regulations should permit employers to provide the SBC by posting it on a website. "A rule permitting website disclosure would be an important step in addressing some of the concerns that the SBC requirement raises for large employers," the letter says.
"ERIC strongly urges the Departments to reconsider the rigid approach that the proposed regulations take with respect to the SBC requirement," Ugoretz said; "[t]he statute does not compel such an inflexible approach, and the proposed template simply would not work for a great many group health plans. Unless the proposed regulations are substantially modified, they will impose unnecessary costs and administrative burdens on employers with no corresponding benefit to employees."
A link to ERIC's comment letter appears below.
For more information:
The ERISA Industry Committee
1400 L Street, NW, Suite 350
Washington, DC 20005
Phone: (202) 789-1400
Fax: (202) 789-1120
The ERISA Industry Committee (ERIC) is a non-profit association committed to representing the advancement of the employee retirement, health, and compensation plans of America's largest employers. ERIC's members provide benchmark retirement, health care coverage, compensation, and other economic security benefits directly to tens of millions of active and retired workers and their families. ERIC has a strong interest in proposals affecting its members' ability to deliver those benefits, their cost and their effectiveness, as well as the role of those benefits in the American economy.
ERIC Comment Letter on Benefit Summaries
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