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Archive for August, 2012

09
Aug

Summary of Benefits and Coverage

Written by dreilly. Posted in Blog, compliance, employee communications, PPACA

Employers must take action.

September 23, 2012 marks the next important date for health plan sponsors under the rules of the Patient Protection and Affordable Care Act (PPACA).  As of this date insurance companies are required to begin providing members a new notice known as a Summary of Benefits and Coverage (SBC). 

The SBC is a document intended to provide health plan members a brief overview in plain language of what the insurance plan covers along with a uniform glossary of important terms.  PPACA requires this notice to be no longer than four pages, front and back, be drafted in 12 font, and be provided in a culturally linguistic manner. 

Health insurance companies are required to provide the notice to members enrolled in individual plans, but for employer plans the health insurance companies will provide the notice to the plan sponsor.  It is then the responsibility of the plan sponsor to distribute the notice to its plan members pursuant to specific timelines prescribed by the Department of Health and Human Services. 

Generally, the SBC must be distributed during the open enrollment process at renewal and also throughout the plan year for new members.  The first notice must be provided beginning with the policy renewal date (effective date for new policies) on or after September 23, 2012.

Plan sponsors should be on the lookout for a communication from the health insurance company, and a strategy to distribute the notice should be incorporated into the administrative process.   Your broker or consultant should guide you through the process.    

Click here for an example of the notice, here for details and instructions as to how to develop the notice.

Testimonials

'We rely on the recommendations of Reilly Benefits to provide plan options for our employees in a way that controls our costs and we feel great relief knowing that they keep us abreast of health care legislation and other issues that affect the managemnent of our plans.'

Regina Anderson
Vice President
Dennis Anderson Construction
'The commitment Reilly Benefits makes to our company to ensure our benefits and claims are handled promptly and correctly goes beyond that of any agency I have seen in my 20 years of working with insurance brokers.'

Karen Siebert, CFO
Great Mills Trading Post
'Our experience with Reilly Benefits has been very positive. The courteous and friendly staff has taken care of our every need. Their knowledge and dedication have afforded us the opportunity to thoroughly explain the benefits and importance of insurance coverage to our employees. I would highly recommend this organization to any individual or business for all types of insurance or tax planning.'

Dottie Wyatt, Controller
Atlantic Cycle & Power
'The commitment Reilly Benefits makes to our company to ensure our benefits and claims are handled promptly and correctly goes beyond that of any agency I have seen in my 20 years of working with insurance brokers.'

Karen Siebert, CFO
Great Mills Trading Post

'Our experience with Reilly Benefits has been very positive. The courteous and friendly staff has taken care of our every need. Their knowledge and dedication have afforded us the opportunity to thoroughly explain the benefits and importance of insurance coverage to our employees. I would highly recommend this organization to any individual or business for all types of insurance or tax planning.'

Dottie Wyatt, Controller
Atlantic Cycle & Power

Benchmarks

Reilly Benefits, Inc. works with employers in a wide variety of industries. This allows us to understand the uniqueness of specific benchmarks within certain industries and among different market sizes.

Our ability to help employers compare and contrast a benefit plan to these benchmarks provides our clients an advantage in the ultimate goal to attract and retain quality employees.

Professional Employee Benefits Specialists

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Reilly Benefits, Inc

5419 Deale-Churchton Rd. Churchton, Md. 20733

Professional Employee
Benefits Specialists

Telephone: 1-410-867-0261

Fax: 1-410-867-0262
info@reillybenefits.com

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