Summary of Benefits and Coverage

Under health care reform, starting in 2012, health insurers and self-funded employers must provide a Summary of Benefits and Coverage to people who apply for and enroll in health plans. The Patient Protection and Affordable Care Act ensures that plan documents include a:

  • Standard glossary of medical and insurance terms
  • Four-page overview of plan benefits, cost sharing and limitations
  • Standard set of examples of how the plan works

The Summary must also include a web address where the individual coverage policy or group certificate of coverage can be accessed. The penalty for non-compliance is $1,000 for each plan enrollee.

Cigna is focused on clear coverage explanations for our plan participants. We will comply with the government regulations for uniform benefits. However, we do see areas that can be improved and have provided recommendations in our position paper.

 

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