On April 6th, 2016, the Departments of Labor (DOL) and Health and Human Services (HHS) issued the final revised template and related materials for the summary of benefits and coverage (SBC) document. Please click here to view a PDF copy of the updated template.
Here is a brief overview of what you may need to know:
- What is the SBC? The SBC is a concise document providing information about health plan coverage and costs. Group health plans and health insurance issuers have the responsibility to ensure that an SBC is created and distributed to employees.
- When does the new template go into effect?: Plans with annual open enrollment periods must start using the new template on the first day of the first open enrollment period that begins on or after April 1, 2017, with respect to coverage for plan or policy years beginning on or after that date. Plans without an annual open enrollment period must start using the new template on the first day of the first plan or policy year that begins on or after April 1, 2017.
- What are the key changes to the SBC? While the updated template is a bit shorter than the current SBC template, a few changes were introduced. This includes:
- Links were added to the uniform glossary on a variety of terms, many of which are found in the updated Introduction paragraph
- The “Important Questions” section has been revised to include a question about services covered before the deductible is met.
- A new coverage example was added that addresses coverage for a foot fracture; it provides information about what a plan covers in an emergency scenario
I hope that you find this brief overview helpful. I encourage all clients to log-in to the CBGconnect portal and download our ACA Compliance Bulletin for more information about this topic.
If you have any questions in the meantime, please contact our team at 781-759-1222.