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Insurers behind on benefits documentation

Under the Patient Protection and Affordable Care Act, all health insurance providers must provide a summary of benefits and coverage document within seven days of an application, renewal or first day of coverage. If the insurance provider fails to do so, they will receive a financial penalty from the U.S. Department of Labor and U.S. Department of Health and Human Services.

Despite the provision of the healthcare reform law going into effect at the end of September, many health insurance providers are reporting difficulty in providing the documentation to insurance applicants and employers in a timely manner. Many providers arguing their application process is online, so drafting a paper document of the information is more time-consuming. Some would prefer to have an online submission portal to share the documentation with applicants directly.

While insurance providers are adapting to certain provisions under the healthcare reform law, the federal government has started to issue grants to the states to help each one establish its own health insurance exchange for residents and employers. So far, the federal government has spent $2.2 billion on funding the exchanges, which create a web-based shopping channel where employees and employers can get more information on coverage and purchase policies.

National Insurance Services is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Readers are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the readers’ business activities.

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Valerie Ortiz

Valerie Ortiz

Over the past 20 years, Valerie Ortiz has worn many hats at National Insurance Services. She currently heads up NIS’ Marketing Team where she helps to create and execute employee benefit communications based upon our public sector clients’ needs. Valerie brings order to the chaos and has a zeal for detail and a talent for organization.