Guest Article

(From the March 26, 2012 issue of Deloitte's Washington Bulletin, a periodic update of legal and regulatory developments relating to Employee Benefits.)

List Released of Counties for Which "Culturally and Linguistically Appropriate" Notices Will Be Required for 2012

The Department of Health and Human Services released the list of counties in the United States for which certain group health plans (and issuers offering health insurance coverage) will be required to provide relevant notices in a "culturally and linguistically appropriate manner" for 2012.

The list, which will be updated annually, identifies those counties in which 10 percent or more of the population is literate only in the same non-English language. Counties are identified in Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Illinois, Iowa, Kansas, Minnesota, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Texas, Utah, Virginia, Washington, and Puerto Rico. There are four relevant non-English languages: Spanish, Chinese, Tagalog and Navajo.

Non-grandfathered group health plans with participants in the listed counties will have to provide notices under the plan's internal claims review process in a "culturally and linguistically appropriate" manner. Both grandfathered and non-grandfathered group health plans will have to provide the new Summary of Benefits and Coverage and related uniform glossary (which are required to be provided, for the first time, by the first day of the first open enrollment period that begins on or after September 23, 2012) in a "culturally and linguistically appropriate" manner.

What does the "culturally and linguistically appropriate" requirement entail? The plan must provide oral language services in the non-English language, and the notices that are sent to addresses within the listed counties must include a statement in the applicable non-English language clearly indicating how to access the plan's language services. (A sample statement, in each of the four relevant non-English languages, is provided in the Labor Department's Model Notice of Adverse Benefit Determination.) If requested, the plan must also provide the notices in the non-English language.

The information in this Washington Bulletin is general in nature only and not intended to provide advice or guidance for specific situations. If you have any questions or need additional information about articles appearing in this or previous versions of Washington Bulletin, please contact: Robert Davis 202.879.3094, Elizabeth Drigotas 202.879.4985, Mary Jones 202.378.5067, Stephen LaGarde 202.879-5608, Erinn Madden 202.220.2692, Bart Massey 202.220.2104, Tom Pevarnik 202.879.5314, Sandra Rolitsky 202.220.2025, Deborah Walker 202.879.4955. Copyright 2012, Deloitte.