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Labor Department revises employer health care benefit summary requirement

Posted On: Feb. 26, 2016 12:00 AM CST

Employers would be required to add simple fractures to this list of examples of how their health care plans provide coverage in certain specific situations under newly proposed Labor Department rules.

Like current rules, the summary of benefits coverage statement would have to give examples of how coverage applies in two specific situations: having a baby and managing Type 2 diabetes. The examples will have to provide sample costs of treatment.

Under the latest rules, released Thursday, employers also would have to detail how coverage applies in a third situation: simple fractures.

When finalized, the rules are expected to apply for the 2017 plan year, which means that employers would have to make the new forms available to employees when making health plan election during the 2017 open enrollment season, which typically begins in October and November.

“Employers would have to update these forms fairly quickly,” said Rich Stover, a principal at Xerox HR Services in Secaucus, New Jersey.