Posted by
Phil Lamb on Thu, Aug 18, 2011 @ 09:18 AM
HRMS is such a powerful tool that we sometimes forget the significant value that some of its most basic features bring to the table.
For example, Employee Self Service (ESS) allows employess to securely log in to a portal that provides relevant benefit and other HR information.
Benefits Pro just released an article that provides an excellent example of how employee self service (ESS) can help companies comply with important regulations from the Department of Health and Human Services (HHS) related to health care disclosures.
"Today, many consumers don't ave easy access to information in plain English to help them understand the differences in the coverage and benefits provided by different health plans,” said HHS Secretary Kathleen Sebelius. “Thanks to the Affordable Care Act, that will change."
The rules proposed today will enable consumers to both more easily understand the coverage they already have and, when purchasing new coverage, to make comparisons of available options. The proposed regulations will ensure consumers have access to two forms that will help them understand and evaluate their health insurance choices, including:
- An easy to understand Summary of Benefits and Coverage; and
- A uniform glossary of terms commonly used in health insurance coverage, such as “deductible” and “co-pay”.
In both instances, employee self service (ESS) can help companies effectively and efficiently communicate these requirements to their employees. Moreover, employee self service (ESS) enables companies to document their compliance. This is true with many other examples of HR compliance-- an HRMS leaves an audit trail of HR communications and employee decisions.
“Workers and their families need clear and understandable information regarding their health coverage," said Secretary of Labor Hilda L. Solis. "Today's proposal is a common-sense step that will help workers quickly and easily compare different coverage options, in order to make more informed decisions."
Under the regulations, health 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 some cases today, health plans and issuers only provide selective details on the plan or policy before it’s purchased, giving consumers a limited understanding of what they are buying.
Employee self service through HRMS provides benefit statements and opportunities for disclosure through links, documents and custom text.
As the BenefitsPro article described:
"The proposed rules give consumers straightforward, standardized information on their choices upfront, helping them understand the key features of the policy or plan and allowing them to make a more informed decision. The summary will use a uniform glossary to replace the jargon that makes it impossible to compare plans or figure out what is covered."
Health plans and issuers must also provide notice at least 60 days before any significant modification is made in the plan or coverage during the plan or policy year.
This Summary of Benefits and Coverage will include a new, standardized health plan or policy comparison tool for consumers known as “Coverage Examples,” much like the Nutrition Facts label required for packaged foods.
Coverage Examples would also illustrate the proportion of care expenditures a health insurance policy or plan would cover for common benefits scenarios—e.g., child birth, breast cancer, and diabetes.
Also, employee self service (ESS) can provide supplemental information to the employee population through customizable links and documents. These can be modified at any time by the HR administrator.
The examples will help consumers understand and compare their share of the costs of care under a particular policy or plan, and see how valuable the health plan will be at times when they need the coverage.
