On February 25, 2016, The Centers for Medicare and Medicaid Services (CMS) released a proposed revision to the way health plans create their Summary of Benefits (SB) documents. Within the notice, it stated that HPMS will no longer generate the SB, and that plans would develop their own SB based upon their bid data within HPMS.

Although CMS has not yet provided guidance on exactly how health plans are to create these materials in the future, it’s highly possible that health plans will be directed to create their SBs through a model document methodology similar to what CMS issues for the creation of the ANOCs and EOCs. It’s also possible that health plans will be allowed to create an SB template that is much shorter than the National Association of Insurance Commissioners’ (NAIC) recommended template.

If a model document methodology is introduced, it would allow health plans the ability to develop the Summary of Benefits through a standardized template process, which can decrease the opportunity for errors and streamline the development of these materials.

If this process change does occur, CodySoft® will easily support health plans with the upcoming process change. Health plans that are currently using, or intend to use CodySoft® for the creation of their ANOCs and EOCs will be able to create versions of their SBs, as well. The result: a simplified and more controlled materials creation process.

And as we all know: more control equals fewer errors.

The CodySoft® Collateral Management Module® is a project management system and tracking tool that delivers:

  • Increased efficiency and auditing
  • Reduced document errors
  • Management and tracking capabilities
  • Ability to link SBs to the source of truth document
  • Simplified creation of marketing collateral, ANOCs and EOCs, and more

The above are only a few ways CodySoft® can support health plans with the upcoming guidance that is expected to be released from CMS this spring regarding how plans will create their SBs. Being prepared for this change and finding a tool that that will help create, manage, track and simplify the process is key.

Contact us today to learn more.