New SBC Template

The Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Labor released materials and supporting documents for a new Summary of Benefits and Coverage (SBC). The new documentation must be used for plan years beginning on or after January 1, 2021.

A Summary of Benefits and Coverage is an easy-to-read summary of health coverage that allows an individual to compare costs and coverages among health plans in order to make an informed decision about benefits. The SBC describes a health plan’s costs, benefits, coverage, services and other features such as cost-sharing and exclusions from coverage. All health plans are required to use the same format for the SBC to ensure consumers can compare like information.

CMS sets the standards for what the SBC must include. The SBC is typically included with enrollment materials. The new CMS guidelines, which may be reviewed by clicking here, will require updates to the SBC for the 2021 policy year.

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