The Department of Health and Human Services, the Department of Labor and the Department of Treasury issued final rules on the Summary of Benefits and Coverage (SBC) and Uniform Glossary. The new rules implement the regulations proposed in December 2014.
Health care reform requires health insurance issuers and group health plans to provide information about coverage through an SBC. The SBC provides a description of plan benefits, intended to give participants an understanding of what is covered under their plan. It is also intended to allow participants the ability to compare their coverage to other plan options. The SBC must be distributed to participants and beneficiaries when they first enroll in coverage, during the open enrollment period, and at other specified times.
The guidance makes few changes to the proposed rules. The guidance does provide that health insurance issuers must provide online access to a copy of the individual coverage policy for each plan or group certificate of coverage.
The new SBC rules apply for plan years beginning on or after September 1, 2015. The guidance anticipates a new template being available by January 2016. All employers should review the rules when planning open enrollment for the 2016 plan year.