Update from Purchasing Alliance Solutions: Patient Protection and Affordable Care Act (PPACA) Employer requirement effective

Thanks to Purchasing Alliance Solutions for always keeping our members updated!

The Summary of Benefits and Coverage (SBC) is a requirement of the Patient Protection and Affordable Care Act (PPACA), the new Federal Healthcare Law, and must be provided to covered members — for some as early as September 23, 2012.

The final regulation requires SBC disclosures to members by the following effective dates:

Participants and beneficiaries who enroll or re-enroll in group health coverage through an open enrollment period (including re-enrollees and late enrollees) beginning on the first day of the first open enrollment period that begins on or after Sept. 23, 2012

Participants and beneficiaries who enroll in group health plan coverage other than through an open enrollment period (including individuals who are newly eligible for coverage and special enrollees) beginning on the first day of the first plan year that begins on or after Sept. 23, 2012.

Since you, as an employer, have a legal obligation to provide the SBC to your members, we are providing you with tools to help you understand the requirement as well as to comply.

When it comes to delivering SBCs to members at renewal, UnitedHealthcare has chosen to assist their covered employer groups and is easing the burden by distributing the SBCs directly to members as required for renewal. Please note that in the pre-enrollment situation, UnitedHealthcare will be relying upon the employers, or brokers acting on their behalf, to deliver the SBC to members at enrollment and to new hires mid-year, because UnitedHealthcare will not know the identities of these eligible but un-enrolled members.

To learn more about SBC and how it impacts you, UnitedHealthcare offers a brief video that explains the Summary of Benefits and Coverage in an understandable and entertaining way, as well as offers the following materials for your reference. United for Reform Resource Center  UnitedHealthcare SBC Employer Guide  Summary: SBC and Uniform Glossary – Final Rule (PDF)Uniform Glossary (PDF) Sample Full SBC (PDF) Sample Partial SBC (PDF)
There is a great deal of information in the above links. Your broker, Chamber and PAS stand ready to assist with questions.

Thank you for your partnership and the opportunity to serve you!