Paragon Solutions, an advisory consulting and systems integration firm, has finalized a deal to deliver a Summary of Benefits and Coverage Solution for a health insurer to help it meet the government-mandated deadline for fall of 2012.
Paragon has not named the health underwriter, but said that the firm manages more than 750-thousand members.
Under the deal, Paragon will cater a concise and comprehensive Summary of Benefits and Coverage in accordance with federal guidelines to current and potential health plan participants starting September 2012.
The Summary must provide members with the ability to understand and evaluate their health insurance choices and it must be made available to participants when coverage is started, modified, or as requested, said the firm.
Paragon director of insurance solutions Tom Brennan said the ruling has left a number of health insurers scrambling to determine how they can address the mandate by the September deadline.
"Many of the firms we’ve spoken to were looking at stop-gap measures to address the demand until they realized there was an automated, more productive way to comply," Brennan said.
"This insurer took a route that will significantly reduce the risk of non-compliance. The penalties for non-compliance can quickly become costly. The failure penalty is $1,000 per failure – and each enrollee can be considered an independent failure."
As per the guidelines issued by the government, the summary must be clear, consistent and comparable, which can be paper or electronic, and should be easy to understand.