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New Standardized Forms Could Simplify Shopping For Health Insurance

Ruby de Luna

Just in time for open enrollment season — insurance companies are required to explain health benefits in plain language. As KUOW's Ruby de Luna explains, the new requirement is part of the Affordable Care Act that takes effect this week.


Whether you're shopping for health insurance, or you get coverage through work, you'll have some new tools to help you choose. First, there will be a glossary of health insurance and medical terms. The list should be easy to read and understand.

Also, there will be a summary of benefits form. This gives a breakdown of what a health plan will cover, how much the insurance will pay, and how much would be the consumer's responsibility.

So let's say you're expecting a baby. The summary will list the hospital charges, labs, doctor fees, and other expected costs related to delivery. Then it would break down what insurance would cover, and what the consumer pays.

Stephanie Marquis is spokesperson for the state office of insurance commissioner. She says the new format should help people compare health plans.

Marquis: "Things like that will help you understand how much you're really going to pay for that plan, compared to just what you pay every month for the premium. Sometimes you may pay a lower premium but actually your out–of–pocket costs could be substantially more than if you chose a plan that maybe had a slightly higher premium."

Officials hope a standardized form will provide important information just like nutrition labels do for food.

I'm Ruby de Luna, KUOW News.

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