Consumer Information (B) SubgroupThe Consumer Information (B) Subgroup will lead the NAIC’s efforts to implement two key consumer information and enrollment provisions of the Patient Protection and Affordable Care Act of 2010 (PPACA). Section 2715 of the Public Health Service Act (PHSA), which was added by Section 1001(5) of the PPACA, requires that the Secretary of Health and Human Services (HHS) develop standards for a summary of benefits and coverage explanation for individual and group health insurance. In developing these standards, the law directs the Secretary to consult with the NAIC, along with a working group composed of representatives of health insurance-related consumer advocacy organization, health insurance issuers, health care professionals, patient advocates including those representing individuals with limited English proficiency, and other qualified individuals. The PPACA also adds Section 715 to the Employee Retirement Income Security Act (ERISA) and Section 9815 to the Internal Revenue Code (the Code) to make these provisions applicable to group health plans and health insurance issuers providing health insurance coverage in connection with group health plans. Section 1311(c)(F) of the PPACA requires that the Secretary of HHS establish criteria for the certification of qualified health plans offered through the American Health Benefits Exchange. This criteria shall require that, amongst other requirements, qualified health plans offered through the Exchange utilize a uniform enrollment form that takes into account criteria that the National Association of Insurance Commissioners develops and submits to the Secretary. |
| Federal Register Notice of Proposed Rulemaking: Uniform Glossary and Summary of Benefits and Coverage |
Final July 2011 Submission to HHS and DOL |
Uniform Enrollment Criteria |
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