On March 23, 2010, Americans were promised that we would soon have a standardized method to compare Major Medical health insurance plans. The first paragraph of Section 2715 of the Patients Protection and Affordable Care Act, aka Obamacare, reads,
“Not later than 12 months after the date of enactment of the Patient Protection and Affordable Care Act, the Secretary shall develop standards for use by a group health plan and a health insurance issuer offering group or individual health insurance coverage, in compiling and providing to enrollees a summary of benefits and coverage explanation that accurately describes the benefits and coverage under the applicable plan or coverage.”
In other words, health insurance consumers were promised that the Secretary of Health and Human Services would complete develop this tool by March 23, 2011. Health insurance companies were required to start providing this information to customers by March 23, 2012.
The Secretary of Health and Human Services failed to meet the requirements of the law. Whether her failure was justified or not is not the point of this post. It is up to the American people to decide if the delay was justifiable.
My point is that it did not happen on the schedule we were told. However, finally, all the kinks have been taken out of the system. The new tool will be available for all major medical policies that renew or start after September, 23 2012.
Click on the sample below to see what the proposed comparison tool will look like.
The new law requires that your insurance company provides you with a completed copy every time your current health insurance plan renews. You are also supposed to be provided a completed copy between the time you apply for health insurance and when your policy is approved. (That way, you know if the policy you applied will actually meet your health insurance needs.)
The new tool can be used in a couple of different ways.
The tool is designed to allow you to compare your health insurance options. If you are shopping for health insurance, you can print off a couple of blank copies. Complete a separate one for each plan that you are considering and compare them to see which plan best meets you needs.
Just be aware that plans can change during underwriting with riders and waivers. Keep the comparison worksheet for the plan you apply. Compare the one your insurance company gives you with the one your used while shopping. They should be identical. If they are not, something happened between the time you submitted your application and when your final policy was approved. You need to know what the change was, why it happened and what it means to you.
During the Health Care Reform debates of 2009-2010, we were bombarded with stories about American’s who had to file for bankruptcy even though they had health insurance. We were told that congress must pass the PPACA in order to eliminate that problem.
One of the problems is that most major medical plans have “cost-sharing” features, like deductibles, co-pays and co-insurance. In many cases, the people who had to file for bankruptcy had the wrong health insurance plan.
As expensive as health insurance is, many people look only at price. This tool forces you to consider the benefits as well as the price. If you find that the plan, in which you are interested, has a weakness, talk to the insurance agent you trust. There may be an affordable supplement that you can add to create a health insurance portfolio that meets your needs.
If you do not already have an insurance agent whom you trust, I would like to be considered for the job. Use the form to your right to let me know what you want to accomplish.