Summary of Benefits and Coverage - Anthem Health Care Reform ...

Distribution
Mail, fax and email are viable distribution channels subject to various detailed requirements
1. Group Business (Small Group, Large Group, National Accounts)
o Requests for medical information/application
o Pre-enrollment for participants to compare during the selection process
o Issuance of policy/certificate
o Renewal/Material Modification
2. Individual (Under 65)
o Shopping/Time of Application
o Issuance of policy/certificate
o Upon Request
o Renewal/Material Modification
Material Modification and 60-day Advance Notice applies to changes during a policy period – it does not
apply to changes made at renewal.
Final Rule Outcomes
A review of the final regulation indicates that the agencies made only several min or changes. Below is a recap of
the requirements in the final rule:
Item
Final Rule
Compliance Date Individual coverage issued on or after September
23, 2012
Group coverage for open enrollments beginning on
or after September 23, 2012
Culturally and
Linguistically
Appropriate
Renewals
The agencies will provide translations of the SBC template,
sample language, and the Uniform Glossary in the languag es
of Spanish, Tagalog, Chinese and Navajo.
The agencies provided flexibility in that if the policy has not
been issued or renewed prior to 30 days before the renewal
date, the SBC must be provided as soon as practicable but
no later than 7 business days after issuance of the new policy
or receipt of written confirmation of intent to renew,
whichever is earlier.