Published on January 20, 2012

Brief Health Care Reform Update

Many of you following the world of health care reform saw a couple of interesting developments toward the end of the year: the release of the essential benefits guidance and the delay of the uniform explanation of coverage (also known as the consumer information provision). The essential benefits guidance basically pushed the key decision making on what an essential benefits package should entail back into the hands of the states. While this has been heralded as a positive development for states and the insurance industry, it didn’t help bring any immediate answers for businesses or individuals on what the actual benefit requirements will be –or whether this will have a positive or negative impact on their benefit costs in 2014 and beyond. Like many other key provisions of health care reform, we’ll have to wait and see what happens.

The uniform explanation of coverage provision has been rather controversial with the health insurance industry because the provision doesn’t seem to account for the inherent differences in the purchase (and Underwriting) process between an Individual consumer, a small group purchaser and a large group purchaser. The provision guidance also did not get released in a timely fashion so the implementation timeline had become very compressed for insurers and administrators to meet. Fortunately, the March 2012 implementation deadline was suspended by HHS shortly before the end of the year. We have not received any further guidance on a revised timeline/due date for this provision, but we will share information as soon as we know more about the revised plan for this provision.