Summary of Benefits Coverage Requirement

September 13, 2012

Starting September 23, 2012, insurance companies must provide a Summary of Benefits Coverage (SBC) form to individual policy holders and to their insured employer plans. Employer plans (self-funded and insured) must provide a SBC for open enrollment periods on or after that date (open enrollment in the 4^th quarter of 2012 for calendar year plans.). Also, employer medical plans must provide employees and beneficiaries with a uniform glossary of terms commonly used in health insurance coverage (such as co-payment, deductible, home health care, etc.). In addition, the regulations include a new requirement to provide a 60-day advance notice of material plan modifications.