ACA Implementation FAQ Part 63 Addresses Culturally and Linguistically Appropriate Notice Requirements

Published November 28, 2023

​The Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the Departments) released Affordable Care Act (ACA) Frequently Asked Questions (FAQs) Part 63 discussing implementation of certain provisions of the Affordable Care Act (ACA) and the Consolidated Appropriations Act, 2021 (CAA).

The Public Health Service (PHS) Act section 2719 and its regulations require non-grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage to provide a summary of benefits and coverage (SBC) as well as claims and appeals notices in a culturally and linguistically appropriate manner.

The regulations implementing section 2719 require these plans and issuers to make certain accommodations for notices sent to an address in a county meeting a threshold percentage of people who are literate only in the same non-English language. For this purpose, an applicable non-English language, with respect to an address in any United States county to which a notice is sent, is an applicable non-English language if 10 percent or more of the population residing in the county is literate only in the same non-English language, as determined based on American Community Survey (ACS) data published by the United States Census Bureau.

The regulations implementing PHS Act section 2719 require these plans and issuers to provide:

  1. oral language services (such as a telephone assistance hotline) that include answering questions in any applicable non-English language and providing assistance with filing claims and appeals (including external review) in any applicable non-English language
  2. notices in any applicable non-English language, upon request; and
  3. in the English versions of all notices, a statement prominently displayed in any applicable non-English language clearly indicating how to access the language services provided by the plan or issuer (referred to as taglines).

Non-grandfathered group health plans and health insurance issuers offering non-grandfathered health insurance coverage are required to provide the SBC as well as claims and appeals notices in a manner that is consistent with the 2023 CLAS Guidance effective for plan years (in the individual market, policy years) beginning on or after January 1, 2025.


Additional Resource

County Data for Culturally and Linguistically Appropriate Services (CLAS County Data)