Summary of Benefits and Coverage (SBC)

August 21, 2012

The Final Regulations require that the Summary of Benefits and Coverage (SBC) be presented in a uniform format that does not exceed four pages in length and does not include print smaller than 12-point font.   A uniform glossary of health coverage and medical terms must also be included.

The initial SBC must be distributed to participants and beneficiaries who enroll or re-enroll during an open enrollment  period that begins on or after September 23, 2012.   For newly hired employees and special enrollees who enroll in coverage other than during an open enrollment  period, the SBC must be distributed on the first day of the plan year that begins on or after September 23, 2012 (January 1, 2013 for a calendar year plan).

The obligation to furnish an SBC applies to a group health plan, self-insured or fully-insured, and a health insurance issuer offering group health coverage.

A plan that offers “excepted benefits” is not required to distribute an SBC.  This would generally include a standalone dental or vision plan and most health flexible spending arrangements (health FSAs).

Benefits

Consulting

Innovative solutions for various forms of health and pension plan designs, funding and administrative operations. Learn More

Actuarial

Analysis

rGa has the experience and in-depth knowledge to perform many actuarial and actuarial-related tasks in serving clients.
Learn More

Administrative

Consulting & Support

Our staff has experience and in-depth knowledge to perform a wide spectrum of Administrative Consulting and Support tasks in serving clients. Learn More