Anna Crane · March 2013
81 GEO. WASH. L. REV. 556 (2013)
The health insurance market is a confusing place for most consumers. When trying to determine what services are covered, an individual may have to wade through multiple plan documents and interpret unfamiliar language. Even if a consumer does make such an effort, they may be unable to really understand the terms of their coverage. In an attempt to make insurance a little more understandable, Congress created the Uniform Glossary in the Patient Protection and Affordable Care Act of 2010. This document contains approximately two dozen commonly used insurance terms with easy-to-understand definitions. Every enrollee will receive the Uniform Glossary along with official plan documents, but the terms and definitions are not plan-specific and are not legally binding. Therefore, any given definition in the Uniform Glossary could be entirely different from the actual definition used by the insurer.
This Note proposes that the Uniform Glossary provision is ineffective in its current state, particularly as it relates to employer sponsored insurance. Although Congress explicitly intended the Uniform Glossary to be an informational tool and not binding on the terms of coverage, its intent will be meaningless if consumers cannot rely on those definitions to understand their health insurance coverage. In order to create a truly accessible marketplace, Congress must require insurance plans to use the terms as defined in the Uniform Glossary in all plan documents. This will put consumers in a position to adequately assess the terms of their insurance coverage, to make better-informed purchasing decisions when seeking medical treatment, and to participate in a more efficient and transparent marketplace.
