Page:United States Statutes at Large Volume 124.djvu/159

 124 STAT. 133 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(1) APPEARANCE.—The standards shall ensure that the summary of benefits and coverage is presented in a uniform format that does not exceed 4 pages in length and does not include print smaller than 12-point font. ‘‘(2) LANGUAGE.—The standards shall ensure that the sum- mary is presented in a culturally and linguistically appropriate manner and utilizes terminology understandable by the average plan enrollee. ‘‘(3) CONTENTS.—The standards shall ensure that the sum- mary of benefits and coverage includes— ‘‘(A) uniform definitions of standard insurance terms and medical terms (consistent with subsection (g)) so that consumers may compare health insurance coverage and understand the terms of coverage (or exception to such coverage); ‘‘(B) a description of the coverage, including cost sharing for— ‘‘(i) each of the categories of the essential health benefits described in subparagraphs (A) through (J) of section 1302(b)(1) of the Patient Protection and Affordable Care Act; and ‘‘(ii) other benefits, as identified by the Secretary; ‘‘(C) the exceptions, reductions, and limitations on cov- erage; ‘‘(D) the cost-sharing provisions, including deductible, coinsurance, and co-payment obligations; ‘‘(E) the renewability and continuation of coverage provisions; ‘‘(F) a coverage facts label that includes examples to illustrate common benefits scenarios, including pregnancy and serious or chronic medical conditions and related cost sharing, such scenarios to be based on recognized clinical practice guidelines; ‘‘(G) a statement of whether the plan or coverage— ‘‘(i) provides minimum essential coverage (as defined under section 5000A(f) of the Internal Revenue Code 1986); and ‘‘(ii) ensures that the plan or coverage share of the total allowed costs of benefits provided under the plan or coverage is not less than 60 percent of such costs; ‘‘(H) a statement that the outline is a summary of the policy or certificate and that the coverage document itself should be consulted to determine the governing contractual provisions; and ‘‘(I) a contact number for the consumer to call with additional questions and an Internet web address where a copy of the actual individual coverage policy or group certificate of coverage can be reviewed and obtained. ‘‘(c) PERIODIC REVIEW AND UPDATING.—The Secretary shall periodically review and update, as appropriate, the standards devel- oped under this section. ‘‘(d) REQUIREMENT TO PROVIDE.— ‘‘(1) IN GENERAL.—Not later than 24 months after the date of enactment of the Patient Protection and Affordable Care Act, each entity described in paragraph (3) shall provide, prior Deadline.