The Intelligent Approach to Beating the Deadline for PPACA-Compliant Summaries of Benefits and Coverage

Executive Summary

Stringent legal requirements introduced by the Patient Protection and Affordable Care Act (PPACA) for health plan Summaries of Benefits and Coverage (SBCs) have put pressure on today’s health insurers and group health plans. The compliance deadline of March 2012 seems impossible to meet.

Every health carrier will have some degree of difficulty meeting the strict SBC format requirements. Problems include the tight deadline, technology and data adjustments, resource demands, the possibility of more format changes, and whether or not past methods can be retained. A carrier’s ability to satisfy the requirements is directly related to way the organization currently generates health benefit summaries, whether through manual processes, a homegrown system or an automated, vendor-based system. Compliance will be a struggle for each insurer, though some are better prepared to manage it than others.

The only system available today to help carriers face this issue is VUE Benefit Summary Tool from VUE Software^®. This platform provides an efficient, streamlined and automated system for addressing the urgent problems posed by SBC format requirements.

With various service levels available, VUE Benefit Summary Tool and expert assistance from VUE Consulting Services can extend far beyond simply formatting SBCs to encompass full-scale benefit summary management. The solution facilitates enrollment, reducing manual involvement and providing a secure platform for managing templates, custom summaries, compliance, reporting and more. The resulting quality, consistency, flexibility and agility equip carriers to handle today’s pressures and set the stage for meeting future challenges.

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