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Health Net Announces Details on SBCs

Aug 22, 2012

Summary of Benefits and Coverage and Uniform Glossary

In February 2012, the Department of Labor (DOL) released the Final Rules for the implementation of the Summary of Benefits and Coverage (SBC) and Uniform Glossary. The Final Rule established the new applicability date beginning on the first day of the first plan year, or the first day of open enrollment that begins on or after September 23, 2012.

What you need to know
The SBC is a uniform, eight-page, template that summarizes benefit plan information. Each issuer uses the template to produce an SBC for each specific plan, with information about deductibles, copayments, coinsurance, and more. Attached is a sample SBC for your reference. The Uniform Glossary provides definitions of commonly used health insurance terms and can by accessed by visiting

October 1 renewals are upon us
Under the Affordable Care Act, both issuers and employers are responsible for providing eligible persons with an SBC at certain times, including but not limited to open enrollment, upon application, or upon request. Health Net intends to be fully compliant with the SBC regulation by the September 23, 2012, effective date.

Health Net and employers will need to divide the responsibilities for compliance between them. Health Net is working hard to take the worry out of SBC compliance for your clients. Health Net has created Employer instructions -
click here to review - which provides employers with detailed information about how employers must reproduce and distribute the SBC to their employees once they receive the applicable SBC(s) from Health Net. These instructions will be provided to employers as part of the renewal process, along with the employer’s SBC(s), beginning with the October 1 renewals. Health Net will also provide SBCs and instructions to new groups effective October 1 and later.  Click here to view the sample SBC.

If you and the employer have already received the renewal for October 1 and later, Health Net will send the SBC(s) and employer instructions as a separate attachment.

Health Net will send you this notification so you can be assured your Health Net group clients have the information needed to comply with the SBC regulation.

Note: Health Net will distribute SBCs to Individual & Family Plans (IFP) members.
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