Congresswoman Rosa DeLauro (D-CT) released the following statement today, marking the day health insurance companies will have to begin explaining their policies to consumers in plain English. This "summary of benefits" must be provided to all applicants and enrollees. The requirement was included as part of the Affordable Care Act, the landmark health care reform that Congress passed in 2010 and the Supreme Court upheld last June.
"Before these summaries, consumers often could not figure out what they were getting, since the details of health insurance plans were obfuscated and often buried in lengthy documents full of legal and actuarial terms. Health insurance was a black box, and people practically needed a team of lawyers just to understand the fine print of a coverage policy. As a result, Americans would buy coverage they thought was comprehensive, only to realize once they actually got sick that it had huge gaps.
"So we wanted to make sure moving forward that insurers had to reveal basic information about their plans -- things like deductibles, out-of-pocket expenses and limits, services not covered by the plan -- in a standardized format, so consumers can make head or tail of the plans being offered. The new summaries of benefits and coverage are in plain English and are designed in a way that is much more helpful than the several-hundred page book on a plan that we used to have to sort through when comparing our options. They also include a couple of real life examples of how a plan would work for specific situations.
"Millions of Americans will benefit from these summaries, including over 90 percent of Americans insured through a job-based plan and 2.3 million men and women under 65 in Connecticut -- over 75% of the non-elderly population.
"This is just one of the many benefits we included in the Affordable Care Act. And it is great to see them going into effect, and changing our health insurance system for the better.