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  • Private Market Required to Provide Clear, Comparable Information on Health Plans

    Under the Affordable Care Act (ACA) insurance companies and employers now are required to provide consumers in the private health insurance market with a brief summary of what a health insurance policy or employer plan covers, called a Summary of Benefits and Coverage (SBC). Additionally, consumers will have access to a uniform glossary that defines insurance and medical terms in standard, consumer-friendly terms.

    These tools also will help employers find the best coverage for their business and employees.

    SBC includes a new comparison tool that helps consumers compare coverage options by showing a standardized sample of what each health plan will cover for 2 common medical situations. The comparison tool is modeled on the nutrition facts label required for packaged foods.

    SBC will include information about the covered health benefits, out-of-pocket costs, and the network of providers. The glossary defines terms commonly used in the health insurance market, such as "deductible" and "copay," using clear language.

    Starting this fall, consumers will receive SBC free of charge and in writing from their insurance companies or employers. This information can be requested at any time, but it will also be made available when shopping for, enrolling in, or renewing coverage. It also will be provided whenever information in SBC changes significantly.

    SBC now is available for consumers in the individual health insurance market. For enrollees in group health plans enrolling during an open enrollment period, it will be available during the next open enrollment period that started on or after September 23, 2012. For enrollees who enroll outside of an open enrollment period, it will be available at the start of the next plan year that began on or after September 23, 2012.

    The Center for Consumer Information and Insurance Oversight provides examples of SBC, an SBC template, and the uniform glossary

    Additional information for consumers is available at healthcare.gov

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    Infographic: Visualizing Health Care Costs

    September's Visualizing Health Policy, a new monthly feature in JAMA, illustrates how health care costs in the United States have surged over the past 50 years. The infographic, created by the Kaiser Family Foundation (KFF), shows how health care spending is unevenly distributed within the US population, with only half the population accounting for more than 97% of health care costs; how health care costs are putting pressure on US families; how the United States spends more per person for health care than other countries; and how the cost of health insurance premiums has increased in the past decade for both workers and employers.

    Archived infographics are available on KFF's website

    New NIH Resource Teaches Kids About Sports Injuries

    A free booklet available in English and Spanish from the National Institutes of Health (NIH) aims to teach children and teens how to avoid sports injuries. Suitable for active kids, parents, and coaches, the story features teen soccer player Ana, who sprains her knee during a pick-up game at a family picnic. Ana and her family learn the best way to treat a sports injury promptly to avoid future complications. This new resource also offers specific tips on how to keep sports safe for kids and prevent injuries, such as warming up before exercise and staying hydrated.

    Ana's Story is NIH's second fotonovela, a comic-book style publication popular in the Hispanic/Latino culture that has been used effectively as an educational tool. Isabel's Story, also available in English and Spanish, teaches about osteoporosis and bone health. 

    Free copies of both Ana's Story and Isabel's Story are available to anyone upon request. To order, contact NIH's National Institute of Arthritis and Musculoskeletal and Skin Diseases' information clearinghouse at 877/ 226-4267 or http://catalog.niams.nih.gov/.