Zane Benefits Publishes New Information on the 60-day Material Notice Modification

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An overview of the 60 day material modification rule for employers and health plans

Today, Zane Benefits, the number one online small business health benefits solution, published new information on the 60-day material notice modification.

According to Zane Benefits’ website, the Affordable Care Act (ACA) requires employers to provide 60 days advance notice to participants when making material modifications to their employer-sponsored health plan.

On February 9, 2012, the Department of Health & Human Services (HHS) released the revised Summary of Benefits and Coverage (SBC) regulation and included the notice of material modification rule.

Here are six key things to know about the 60-day notice of material modification:

(1) The requirement affects health plan years beginning on or after September 23, 2012.
(2) The requirement only applies to changes made during the plan year. It does not apply to renewals of coverage or any modifications made as part of the renewal.
(3)The requirement can be met by providing an updated Summary of Benefits and Coverage (SBC) if the change is reflected on the SBC.
(4) Before a material change can be effective, all impacted participants must receive at least 60 days advance written notice of the change.
(5)Plan issuers or sponsors that intentionally fail to provide the notice of material modification are subject to a fine of up to $1,000 for each failure.
(6) A material modification includes:
-Any coverage modification that alone or combined with other changes made at the same time would be considered to be “an important change in covered benefits or other terms of coverage under the plan or policy.”
-An enhancement of covered benefits, services or other more general, plan or policy terms.
-A “material reduction in covered services or benefits,” including changes or modifications that reduce or eliminate benefits, or increases in cost-sharing

Click here to read the full article.
About Zane Benefits
Zane Benefits was founded in 2006 to provide a revolutionized SaaS (Software-as-a-Service) administration platform ("ZaneHRA") for defined contribution health care. The flagship software provides a 100% paperless administration experience to small businesses and insurance professionals that want to offer better health benefits without a traditional group health insurance plan at lower costs. For more information about Zane Benefits, visit

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Christina Merhar
Zane Benefits
800-391-9209 6725
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