HHS released the list of counties for which non-grandfathered group health plans and issuers of non-grandfathered health insurance coverage will be required to provide notices in a "culturally and linguistically appropriate manner" in 2012. The counties include those in which 10% or more of the population is literate only in one of four non-English languages, including Spanish, Chinese, Tagalog and Navajo. The full list can be accessed on the CMS website.

In order to comply with the "culturally and linguistically appropriate" requirements, a plan must provide oral language services in the non-English language, and the notices that are sent to addresses within the listed counties must include a statement in the applicable non-English language clearly indicating how to access the plan's language services. A plan must also provide the notice in the non-English language upon request.