Shopping for Health Insurance Gets Easier

According to a recent McKinsey Consumer Health Insights survey of 11,000 U.S. consumers under age 65, 72% of you are totally confused and overwhelmed trying to compare health insurance policies. But help may be on the way. The Department of Health and Human Services (HHS) has released its proposed standardized form designed to make it easier to understand and compare health care insurance before you buy a health insurance policy.

As of now, you can typically only see the specific details of a health care insurance plan on a Certificate of Coverage, issued only after you’ve enrolled in the plan – making it impossible to effectively compare various health insurance policies on an apples-to-apples basis. The new HHS form is supposed to change that by allowing consumers to access detailed health care insurance information before the purchase.
The six-page HHS form is modeled on one developed by the National Association of Insurance Commissioners (NAIC) and has been compared to the standard nutrition labels found on food. HHS claims it features clear, concise information in an easy-to-read question-and-answer format. Among other things, it includes:

  • A summary of health care plan benefits and coverage
  • Clearly stated deductibles for specific categories
  • Specific out-of-pocket spending limits and expenses that do not count toward the limit
  • How much you can expect to pay for common medical procedures
  • How the plan might cover medical care for having a baby, breast cancer treatment and diabetes management
  • A uniform glossary of commonly used health insurance terms, replacing confusing jargon that can vary from plan to plan

According to a press release on the HHS website: “All health care plans and issuers will provide a Summary of Benefits and Coverage, along with a uniform glossary of terms, to shoppers and enrollees upon request
and before they buy coverage.”  In addition, employers will be required to provide the same plan summary to new hires and all employees during open enrollment periods.

HHS will finalize the proposed form, which can be downloaded at, after an open comment period. The use of the new form is scheduled to take effect in March 2012.

Opponents of the plan claim that it will place an undue administrative burden and cost on insurers.


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