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NAIC to HHS: Keep Group in Loop

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National Association of Insurance Commissioners (NAIC) officers are asking federal agencies to continue to use an NAIC subgroup to help develop, maintain and extend new benefits and coverage summary standards.

The officers talk about a continuing role for the NAIC’s Consumer Information Subgroup in a cover letter submitting the NAIC’s proposal for standard health coverage definitions and standards for benefits and coverage summaries to the secretaries of the U.S. Department of Health and Human Services and the U.S. Department of Labor.

The NAIC developed one set of benefits and coverage summary instructions for individually purchased policies and another for group products.

“There may be additional changes required to the forms and instructions for large self-funded employer plans and for [health maintenance organizations],” the NAIC officials say in their cover letter.

The NAIC did not have the resources to do focus group tests of the proposed standards, but Consumers Union, Yonkers, N.Y., and America’s Health Insurance Plans, Washington, did do some focus group testing, officials say.

Each of the two subgroup teams met, in person or through conference calls, more than 25 times, and each meeting or conference call lasted 2 to 6 hours, officials say.

“Because the subgroup has gained extensive experience during the development of these documents, we believe we are uniquely qualified to consider and facilitate future changes to the summary of benefits and coverage, as well as to the instructions,” officials say. “We propose that the subgroup be utilized to monitor issues identified by consumers, carriers, and employer health plans, as these documents are implemented.”


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