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It provides detailed guidance on the format, content, and requirements for the SBC, including information on the header, disclaimer, important questions, common medical events, disclosures, and coverage examples.
2021 SBC Materials •On February 3, 2020, the Departments of Health and Human Services, Labor, and the Treasury released updated versions of the 2021 Summary of Benefits and Coverage (SBC) Template and related materials following the identification of minor formatting issues, typographical errors, and inconsistencies across documents.
An explanation of what’s not covered and/or the limits on coverage. Information on costs you might have to pay — like deductibles, coinsurance and copayments. Coverage examples, including how coverage works in the case of a pregnancy or a minor injury. A reminder that the SBC is only a summary.
You have the right to an easy-to-understand summary about a health plan’s benefits and coverage. Insurance companies and job-based health plans must provide you with: A short, plain-language Summary of Benefits and Coverage (SBC)
PHS Act section 2715 generally requires all health insurance issuers offering individual health insurance coverage to provide applicants, enrollees, and policyholders with an accurate summary of benefits and coverage (SBC).
This job aid provides information and guidance that Navigators and certified application counselors (collectively, assisters) need to know in order to interpret the Summary of Benefits and Coverage (SBC) for health plans and assist consumers with using the SBC to compare health plan benefits.
SBC documents can help You choose a health plan that best meets Your needs. These documents show how You and Anthem would share the cost for the covered health care services. It also gives You insight into what services are covered.
