Beginning on July 1, 2011 the federal health care reform legislation requires that group health plans make certain notices or communication available for translation into languages other than English when certain group thresholds have been met.

If a certain percentage of the participants in your group health plan are literate only in a language other than English than the insurance provider must offer the participant the option to receive Explanation of Benefits (EOB’s) and certain other notices in the native languages of the participant. Eligibility for the translated documentation is not based on preference but ability. In other words the participant is eligible if he or she can not read or write in English.

The insurance companies are measuring the impact of the legislation through surveys of its clients. Insurance clients are being asked to complete surveys to define the so-called thresholds. The threshold is being defined as :

    • For a plan that covers 99 or less participants at the beginning of a plan year, the threshold is 25 percent of all plan participants being literate only in the same non-English language.
    • For a plan that covers 100 or more participants at the beginning of a plan year, the threshold is the lesser of 500 participants or 10 percent of all plan participants being literate only in the same non-English language.

This will obviously affect companies of all sizes. It isn’t impossible to imagine a small manufacturer with most of it work force not being literate in English. One of our clients has a makeup of 90% non-English speakers. It will be interesting to see how this legislation is enforced and how insurance providers will address the translation of EOB’s without passing on additional administrative costs to participants as well as suffering delays in the dissemination of important notices to participants.

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