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 4th 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.