Insurance Outreach and Education
Educating consumers about their rights and responsibilities under state and federal insurance laws and regulations can help them make better decisions when purchasing and using health insurance.
*Full name: Create a plan for educating consumers about their rights and responsibilities as defined by the ACA insurance provisions.
*Relevance to the ACA:
The ACA provides consumers with a number of new rights and responsibilities. The ACA does not require states to educate consumers, but does make establishing an office of consumer assistance or ombudsman a condition of receiving a consumer assistance grant. Relevant sections of the ACA include:
§1002 - Creates consumer assistance grants for states to establish an office of health insurance consumer assistance or ombudsman. The consumer office or ombudsman is required to assist with consumer complaints and appeals, quantify problems reported by consumers, assist consumers with enrollment, resolve problems with obtaining premium tax credits, and educate consumers about their rights and responsibilities with regard to insurance coverage. States that receive this grant must also report to the Secretary of HHS on the types of problems and inquiries they receive from consumers.
§1311 - Exchanges must require plans seeking certification to publish on a website and through other means information about the amount of cost-sharing (including deductibles, copayments, and co-insurance) under the plan.less