In a new frequently asked question (FAQ) released by the U.S. Departments of Labor (DOL), Treasury, and Health and Human Services on March 30, 2015, the agencies advised the public that they intend to finalize the summary of benefits and coverage (SBC) regulations (proposed on December 30, 2014 and described below) in time to apply to the first year on or after January 1, 2016 (including the open enrollment period that occurs in the Fall of 2015 for coverage beginning January 1, 2016).   The Departments are seeking input from the public and the National Association of Insurance Commissioners (NAIC), and conducting consumer testing on the SBC template and associated documents. The DOL anticipates releasing a new template and additional documents for plan years beginning on or after January 1, 2017 (and the Fall 2016 open enrollment period).

In the December 30, 2014 proposed regulations, the three agencies issued a new template for a streamlined form of SBC notice and a new version of the glossary. The proposed regulations also formalize the guidance provided in earlier FAQs on such subjects as timely delivery of notices, assignment of responsibility for providing notices (to prevent unnecessary duplication), content and coverage example requirements, delivery requirements and enforcement.

As the federal health care reform effort gained steam, Ballard Spahr attorneys established the Health Care Reform Initiative to monitor and analyze legislative developments. With federal health care reform now a reality, our attorneys are assisting health care entities and employers in understanding the relevant changes and planning for the future. They also have launched the Health Care Reform Dashboard, an online resource center for news and analysis on developments under the ACA.

If you have questions about this alert, please contact Jean C. Hemphill at 215.864.8539 or, Brian M. Pinheiro at 215.864.8511 or, Diane A. Thompson at 424.204.4334 or, Edward I. Leeds at 215.864.8419 or, or Sharon M. Marshall at 215.864.8506 or