Summary of Benefits and Coverage (SBC)


Purpose:

To standardize how health plans communicate the coverage available to an individual under that plan


Intent:

To educate individuals about available health coverage and allow individuals to make informed choices between health plans


Health Plans Affected by this Provision:


Year Effective: 2012
Medical Plan: Yes
Dental/Vision Plan: No, if stand-alone benefit excepted from HIPAA’s portability provisions
HRA: Yes, unless stand-alone benefit excepted from HIPAA’s portability provisions
Health Care FSA: No, unless FSA is a non-excepted benefit

Document Downloads:


Document Title Last Updated
 SBC FAQ (via Employee Benefits Corporation)
04/04/2017
 ACA Implementation Part 30 FAQs 03/11/2016
 CMS Webpage for SBC Resources 12/30/2016
 ACA Implementation Part XIX FAQs, May 2, 2014 05/02/2014
 Treasury FAQ, Revised, 2013 SBC  
 DOL SBC FAQ, March 2012 03/01/2012
 DOL SBC FAQ, May 2012 05/01/2012
   
 For use before April 1, 2017:  
 SBC Standard Template
 04/23/2013
 Uniform Glossary  04/23/2013
 Instructions for completing the SBC for Group Health Plans
 04/01/2012
 
 
 For use after April 1, 2017:  
SBC Standard Template  04/06/2016
Uniform Glossary  04/06/2016
Instructions for completing the SBC for Group Health Plans  04/06/2016
Location (map)
1350 Deming Way, Ste 300
Middleton, WI 53562-4640

Mail Address
PO Box 44347
Madison, WI 53744-4347