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The best and the worst development of 2011 concerning health care reform, two benefit experts say, involved the same issue: a reform law requirement that employers provide to employees a summary of their benefits and coverage.
Among other things, the summary of benefits and coverage was to include the portion of expenses that a health plan would cover in three situations: having a baby, treating breast cancer and managing diabetes. Benefit experts said they never had heard of such an approach.
Federal regulators proposed that the new benefit statement be made available to health care plan participants by March 23, 2012, drawing an angry response from the business community and its advisers.
“It was the worst regulatory development, hands down,” said Gretchen Young, senior vp-health policy at the ERISA Industry Committee in Washington. “The regulation—inappropriate for large, self-funded plans—is the worst sort of example of high added costs with no corresponding benefit. In fact, the additional information to be sent to participants is redundant at best and misleading and confusing at worst.”
The good news, said Chantel Sheaks, a principal in the Washington office of Buck Consultants L.L.C., was federal regulators' decision to indefinitely delay compliance with the new requirement.
On the legislative side, the best health care reform law development was passage of legislation to strip a provision that would have required employers, in certain situations, to offer low-wage employees company-paid vouchers to purchase coverage in state health insurance exchanges.
“It would have been a nightmarishly complicated provision for employers to administer and pay for with little offsetting societal benefit,” Ms. Young said.
Repeal “was the best thing that could have happened to the voucher provision,” Ms. Sheaks said.