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Under the Affordable Care Act (ACA), you must receive a Summary of Benefits and Coverage (SBC) document. It explains your benefits. It also has examples of how much you might pay out of pocket for certain health services. All SBCs must follow a standard format.
Instructions. Employer - Complete the Employer Group Information at the top of the form. Employee - Complete Sections A - E. Section A - Type of Activity: Check box(es) indicating reason(s) for submitting this Enrollment/Change Request. Provide Effective Date(s) and Date of Event(s) where requested.
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services.
Princeton University offers a Health Maintenance Organization (HMO) Plan administered by Aetna. Coverage under the HMO Plan is available to you and your dependents as long as you and they meet the eligibility requirements, defined in the About Your Benefits SPD. If you are a non-U.S. citizen in this country on a J-1 Visa, you may enroll in the HMO
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services.
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Health benefits and health insurance plans contain exclusions and limitations. See all legal notices. Get health care tools, manuals, and forms from Aetna to help make your employee benefits administration easier.
