By: HUB’s EB Compliance Team

On November 28, the U.S. Departments of Health and Human Services, Labor and Treasury (the “Agencies”) issued updated guidance regarding the Affordable Care Act (“ACA”) requirement that certain services and notices be provided, or at least made available, in non-English languages.

Background

By way of background, under the ACA, certain services and notices must be provided in a “culturally and linguistically appropriate manner.” This is sometimes referred to as the “CLAS” rule. This rule applies to the summary of benefits and coverage (SBC) as well as certain claims and appeals services and notices. The CLAS rule only applies to non-grandfathered health plans.

Under the rule, a health plan must meet several requirements to be treated as providing the relevant services and notices in a culturally and linguistically appropriate manner. Among other requirements, the plan must provide:

  • oral language services (such as a telephone customer assistance hotline) in any applicable non-English language;
  • upon request, a notice in any applicable non-English language; and
  • Within the English versions of all relevant notices, a statement prominently displayed in any applicable non-English language clearly indicating how to access the language services provided (these are typically referred to as “taglines”).

The applicable non-English languages are determined county by county. Specifically, a language is considered an applicable non-English language if at least 10% of the population residing in the county is literate only in that language. This determination is based on American Community Survey (ACS) data published by the United States Census Bureau. The current list, which was last updated in 2016, is available here.

Updated Language List

On November 28, the Agencies issued updated guidance that lists all counties that meet or exceed the 10% threshold, based on ACS data from 2016-2020. The new list applies for plan years beginning on or after January 1, 2025. Given that the new list does not apply until 2025, plan sponsors and their service providers will have some time to update the applicable taglines within the relevant notices. This new list will remain applicable until a future version of the guidance is issued and effective. Helpfully, the November 28th guidance includes sample taglines in each applicable language.

At the same time, the Agencies also released an FAQ. The FAQ explained the updated guidance and indicated that the Agencies will update certain sample documents on their website to reflect these CLAS updates. This will specifically include the SBC template and sample completed English SBCs with updated non-English taglines, additional translated versions of the SBC and Uniform Glossary; and model notices for internal claims and appeals as well as external review.

Conclusion

In most cases, employers rely on their insurance carriers or other service providers to update the relevant communications to ensure consistency with the CLAS rules. However, employers may want to familiarize themselves with the updated list as it may inform how they address other employee communications in areas of the country where they have key locations where a significant number of employees may speak a particular non-English language.

If you have any questions, please contact your HUB Advisor. View more compliance articles in our Compliance Directory.

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Neither Hub International Limited nor any of its affiliated companies is a law or accounting firm, and therefore they cannot provide legal or tax advice. The information herein is provided for general information only and is not intended to constitute legal or tax advice as to an organization’s specific circumstances. It is based on Hub International's understanding of the law as it exists on the date of this publication. Subsequent developments may result in this information becoming outdated or incorrect and Hub International does not have an obligation to update this information. You should consult an attorney, accountant, or other legal or tax professional regarding the application of the general information provided here to your organization’s specific situation in light of your organization’s particular needs.