Legal Alert: Agencies Provide Updated County Data for Culturally and Linguistically Appropriate Services and Guidance

On November 28, 2023, the Department of Labor (DOL), Internal Revenue Service (IRS) and Health and Human Services (HHS), collectively known as the Tri-Agencies, issued Part 63 of their FAQ series regarding implementation of the Affordable Care Act (ACA) and Consolidated Appropriations Act, 2021. 

The FAQs provide information regarding the most recent American Community Survey (ACS) data published by the U.S. Census Bureau, which lists every county in the country (as well as any U.S. territories) that requires culturally and linguistically appropriate services/taglines in notices and the specific language that applies. 

The 2023 Culturally and Linguistically Appropriate Services (CLAS) County Data Guidance includes sample taglines stating how to access language services group health plans (“plans”) or health insurance issuers (“issuers”) may use in their applicable notices. The CLAS Data Guidance is effective for plan years beginning on or after January 1, 2025.

Reminder: The ACA requires non-grandfathered plans and issuers providing non-grandfathered individual health insurance plans to provide, or make available, claims and appeals notices in a culturally and linguistically appropriate manner when 10% or more of the population residing in the applicable county to which the notice is sent is literate only in the same non-English language. 

Specifically, plans may need to provide oral language services (e.g., telephone hotline assistance related to claims and appeals, including external review), notices (upon request) and, in any notices written in English, a “tagline,” which is essentially a statement prominently displayed in the applicable non-English language that indicates how a participant may access language services provided by the plan or issuer. Moreover, all plans and issuers, including grandfathered plans, must provide a summary of benefits and coverage (SBC) and uniform glossary in a culturally and linguistically appropriate manner. 

In the FAQ, the Tri-Agencies indicate that they intend to:

• Update the SBC and uniform glossary templates (with updated taglines in applicable non-English languages);
• Provide additional translated versions of the SBC and uniform glossary;
• Provide model notices for internal claims and appeals, along with an external review that will include updated taglines in applicable non-English languages). 

Another client alert will be issued once these items are available.

Sources

This alert was prepared by Barrow Weatherhead Lent LLP, a national law firm with recognized experts on the Affordable Care Act. Contact Stacy Barrow or Nicole Quinn-Gato at sbarrow@marbarlaw.com or nquinngato@marbarlaw.com.