Merle Scheiber has stepped up to fix a gap in the new federal “summary of benefits and coverage” (SBC) rules.
The rules, part of the Patient Protection and Affordable Care Act of 2010 (PPACA), require health insurers and group health plans to start providing SBCs for any coverage that started to take effect after Sept. 23.
The PPACA SBC rules are supposed to help consumers and employers shop for high-quality health coverage by giving them the nuts-and-bolts plan information they need to compare the value of the benefits provided.
One challenge: The SBC rules do not say anything about whether insurers or group health plan sponsors or administrations have to mention the price of the coverage, or anything else about the price of the coverage.
Scheiber, the South Dakota insurance director, has tackled the SBC price information hole in South Dakota Insurance Regulatory Bulletin 12-05.
“Unfortunately, the SBC does not contain all of the required disclosures necessary to comply with both PPACA and those state and federal requirements that were already in place,” Scheiber wrote in the letter.