The Departments of Health and Human Services, Labor and Treasury issued proposed rules to add features to the Summary of Benefits and Coverage (SBC).
The SBC is documentation requirement under health care reform. It provides a description of plan benefits. It is intended to allow participants to better understand the coverage they have and be able to compare their coverage to different 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 Department of Labor has a template format that must be used for the SBC.
Proposed changes to that template attempt to make the SBC more user-friendly. They include a new coverage example to better illustrate the cost of services. Examples presently include having a baby and managing Type 2 diabetes. The proposed rules add an additional example that shows cost-sharing related to a broken foot to explain coverage in an emergency situation.
The proposed rules streamline and shorten the SBC to 2-1/2 pages, down from 4 double sided pages. Changes were also made to the Uniform Glossary that is intended to explain insurance terms.
If the proposed rules are finalized, they will be effective for plan years beginning on or after September 1, 2015.
