Translation of Summary of Benefits and Coverage 101

All professionals in the medical industry should have their consumers’ best needs at heart, this includes insurance companies. Generally they do, which is why so much importance is placed on the translation of Summary of Benefits and Coverage (SBC) in the medical industry. 

The role of a SBC is to ensure that consumers are aware of the health benefits and coverage available to them through their healthcare plan. In fact, the Affordable Care Act (ACA) typically requires that any group health plans or health insurance company provide a summary of benefits and coverage that can accurately describe the benefits and coverage available under the plan. While that definition will give you a quick glimpse at why SBCs are so important, let’s dive a bit deeper into this complicated topic and how medical translation comes into play.

What is an SBC?

Alongside helping consumers understand their health plan’s features and offerings, an SBC also covers the costs associated with the plan. An SBC can cover very complicated topics, such as cost sharing rules or limits and exceptions to coverage, in a way that is easy for the average consumer to understand. One way that a health insurance or plan company can do this is by providing consumers with a “Uniform Glossary” designed to clearly explain any medical or insurance-related terms that may apply to a plan. Not only are all plans required by the ACA to provide a SBC to their consumers, but they must follow a a uniform template that is customized to reflect the terms of a specific plan. 

Why do SBCs matter? 

It is of the utmost importance that consumers have access to an SBC. Not only does this access help them understand their plan features and the costs associated with it once they’re enrolled, but they can use the SBC to answer some of their general questions regarding a health plan before they choose to enroll in it. This knowledge helps consumers make informed decisions about their health and finances. 

Why does an SBC need to be translated into other languages?

Because we live in an increasingly global world, diversity must be kept in mind by health plans and insurance providers. A minimum of 350 languages are spoken in homes throughout the United States. While providing SBCs in each of those languages wouldn’t be possible, or even necessary as many of these languages are spoken by bilingual citizens, there are compliance regulations that dictate which languages providers must accommodate. Vital plan information must be available in the 15 non-English languages most commonly spoken in a state or languages spoken by at least 10 percent of a county’s population. The ACA, and other related statutes and regulations, currently have strict language requirements. For example, qualified health plans insurers that have been registered for at least one year are required to provide oral and written translation services to consumers in a minimum of 150 languages.

It is important to remember that the translation of Summary of Benefits and Coverage is not just a matter of compliance, but of inclusion. Providing resources for a growing and diverse population should always be a priority.

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