Final Versions of Revised SBC Template & Related Documents Now Available

New SBC Materials Applicable for Plan Years Beginning On or After April 1, 2017

Federal agencies have finalized new versions of the summary of benefits and coverage (SBC) template, instructions, uniform glossary, and related documents, which are authorized for use on or after April 1, 2017.
 
Background
Under the Affordable Care Act, group health plans and health insurance issuers are generally required to provide a written SBC to plan participants and beneficiaries at specified times during the enrollment process and upon request. The implementation date for using the new SBC template and associated documents will be as follows:

• Health plans and issuers that maintain an annual open enrollment period will be required to use the new editions beginning on the first day of the first open enrollment period that begins on or after April 1, 2017 with respect to coverage for plan years beginning on or after that date.
• Health plans and issuers that do not use an annual open enrollment period will be required to use the new editions beginning on the first day of the first plan year that begins on or after April 1, 2017.

New Changes
The new SBC template includes an additional coverage example as well as language and terms to improve individuals' understanding of their health coverage. Specifically, the new template includes more information about cost-sharing, such as enhanced language to explain deductibles, and requires plans to address individual and overall out-of-pocket limits. Changes have also been made to the SBC to improve readability.  

Visit the U.S. Department of Labor's webpage on the SBC and Uniform Glossary for the latest updates, and to access all available templates and related documents.

Be sure to visit our Summary of Benefits and Coverage (SBC) section for additional information.