NAIC Summary of Health Plan Coverage Ready for Testing

The industry has raised a red flag about the coverage facts labels, which illustrate sample coverage for threes medical scenarios, including treating breast cancer. In a letter to the subcommittee on insurer recommended that the less complex medical conditions should be used in the examples. That’s a good point and certainly reminds everyone of the danger of oversimplification.

“It is a complicated balancing act,” says Susan Pisano, a spokesperson for AHIP. She points to studies that show that consumers are happy with summaries as long as additional information is available elsewhere, like on a web site.

With healthcare reform expected to being millions of new insurance shoppers into the market, the time is definitely right for a summary of benefits and coverage that can be easily presented and understood. But the coverage facts label may need to be tweaked to make sure that in the push to make health benefits understandable, we don’t trip and make the information meaningless.