Mini-med plans must notify customers of limited benefits

Health insurers offering "mini-med" plans must notify consumers in plain language that their plan offers extremely limited benefits, according to new rules issued last week by the Department of Health and Human Services (HHS).

Specifically, insurers must include the dollar amount of the annual limit along with a description of the plan benefits to which the limit applies. In addition to information on caps, other dollar limits in the policy--such as restrictions on the amount of physician office care or hospitalization coverage--must be detailed in letters and enrollment materials. Insurers also must direct customers to www.HealthCare.gov where they can get information about other coverage options, according to Kaiser Health News.

This notice must be prominently displayed in clear, conspicuous 14-point bold type as a part of any informational or education materials, as well as in plan or policy documents provided to enrollees, Gov Monitor reports. The notices must go out within 60 days.

HHS also released new rules on when mini-med plans can continue to be sold. Under limited circumstances, insurers that have obtained a waiver of the annual limit requirement can sell policies to new employers and individuals. For example, an employer that already offers a mini-med policy with a waiver may buy a new mini-med plan from a different insurer under certain circumstances. In addition, HHS is allowing mini-med policies to be sold in states operating programs that provide health coverage with low annual limits or require insurers to offer coverage with low annual limits, where either the state or the insurer has a waiver, according to Gov Monitor.

To learn more:
- read the Kaiser Health News article
- read the Gov Monitor story
- read the HHS guidances

Related Articles:
Mini-med health plans offer false sense of protection 
SPOTLIGHT: HHS to address medical-loss ratio and 'mini-med' plans

Suggested Articles

Humana filed suit Friday against more than a dozen generic drugmakers alleging the companies engaged in price fixing.

Medicare Advantage open enrollment kicked off last week, and insurers are taking new approaches to marketing a slate of supplemental benefit options. 

Centene announced another five states have approved its pending $17B merger with WellCare, bringing total number of approvals to 24.