Dive Brief:
- The Department of Labor’s employee benefits arm proposed a rule Wednesday that would allow insurers to share mandatory group health plan disclosures with their beneficiaries electronically.
- Many of the communications, like summary plan descriptions, claims denials or notices that coverage can continue after a job loss, are currently sent via physical mail. But if the rule is finalized, plans will be able to post the documents online and notify a member by text or email when a disclosure is available.
- It’s “a big step forward in how Americans receive important information about their health benefits,” Daniel Aronowitz, who leads the DOL’s Employee Benefits Security Administration, said during a press briefing.
Dive Insight:
The DOL estimates the proposal could save insurers $3.9 billion over a decade by lowering the costs of printing and sending paper disclosures to their members. Group health plans currently print and mail up to 11 billion sheets of paper each year, regulators said.
Moving to e-delivery will also more convenient and secure for beneficiaries, according to the DOL, though people can still request to receive their disclosures physicially if they prefer.
It’s “a win for participants and beneficiaries, a win for employers, a win for efficiency,” Aronowitz said.
Electronic delivery rules under the Employee Retirement Income Security Act, the federal law that oversees employee health benefits, haven’t been modernized since 2002. Currently, only individuals considered “wired at work” — with access to a computer and email address provided by their employer — or who provide affirmative consent can get their disclosures digitally.
As a result, working Americans not based in an office haven’t been able to get electronic delivery of notices. The propose rule would create a new safe harbor for group health plans to use electronic media — like email or web portals — to send documents to those members.
The DOL doesn’t have firm estimates of how many working Americans aren’t currently benefiting from e-delivery that will under the proposed rule. However, the regulation would apply to more than 134 million participants in 2.7 million ERISA-covered plans nationwide, according to regulators.
It’s part of the DOL’s larger push to ensure plan notice requirements are up to date. In 2020, the department modernized electronic delivery rules for retirement plans.
The healthcare industry has been moving towards greater electronic interchange of information, spurred by federal regulators across multiple administrations as Americans increasingly live, play and work online. It’s been a focus of the second Trump administration, which launched a “health tech ecosystem” last summer bringing hundreds of companies together to adopt federal standards for data exchange and expand patient access to medical data via apps.
Insurers have also worked to expand consumers’ electronic and app-based data access, with the goal of making it easier for Americans to review claims, find in-network providers, view digital insurance cards, chat with member support and more online. It’s one strategy from the industry as it works to improve souring public sentiment stemming from barriers to healthcare access, the rising cost of care and disjointed and confusing processes that make it difficult for consumers to understand and utilize their plans.
