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Summaries of Benefits and Coverage (SBCs) and claims and appeals notices of non-grandfathered health plans are required to include foreign language tag lines in certain counties identified by federal regulators as having 10% or more of the population literate only in the same non-English language.  These tag lines let these individuals know how they can get a full SBC, other notices, and live assistance in the specified non-English language.

The list of counties is periodically updated based on American Community Survey (ACS) data published by the United States Census Bureau.  The last county list was issued in January 2016, but a new county list is now available in .  Group health plans must use the 2023 county list starting with plan years beginning on/after January 1, 2025.

Along with the original four languages which remain (Spanish, Chinese, Navajo, and Tagalog), the 2023 update includes four new foreign languages:

• Pennsylvania Dutch
• Samoan
• Carolinian
• Chamorro

Employers will want to review the which is sorted alphabetically by state/territory, then alphabetically by county.  Some notable Spanish language updates include:

• Colorado: removed Adams, Morgan, and Saguache counties, and added Garfield County which joins Costilla, Eagle, and Phillips counties remaining on the list
• Kansas: removed Edwards, Stanton, and Stevens counties, which keeps Finney, Ford, Grant, Hamilton, Haskell, Seward, and Wyandotte counties on the list
• Missouri: removed Sullivan County, which leaves no counties on the list for Missouri
• New York: removed New York County, leaving just Bronx and Queens counties remaining for the whole state
• Washington: added Chelan County, which joins Adams, Douglas, Franklin, Grant, and Yakima counties remaining on the list

IMA will continue to monitor regulator guidance and offer meaningful, practical, timely information. This material should not be considered as a substitute for legal, tax and/or actuarial advice. Contact the appropriate professional counsel for such matters. These materials are not exhaustive and are subject to possible changes in applicable laws, rules, and regulations and their interpretations.