Benefits Update, No. 4, November 2012: Are You Using "Culturally Appropriate" Language?

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The Patient Protection and Affordable Care Act (PPACA) requires group health plans to distribute four-page plan summaries to enrollees. These Summaries of Benefits and Coverage (SBCs) are subject to a "culturally and linguistically appropriate" standard, meaning that when the SBC is distributed to an enrollee at an address in a county where, according to the federal government, at least 10% of the citizens are fluent only in the same non-English language, the summary must include a prominent offer of language assistance in that non-English language.

Non-grandfathered plans must also satisfy this culturally and linguistically appropriate standard with respect to the plan's claims and appeals process.

The offer of language assistance need only be a single sentence, but it must clearly indicate how to access the language services provided by the plan. In addition, the plan must provide oral language services (such as a telephone number) that include answering questions about the document in the relevant non-English language and must supply a copy of the document in the relevant non-English language, upon request.

For a list of affected counties, by state, see the HHS website.

For more information contact the author at CCarter@laborlawyers.com or (415) 490-9000.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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