The Department of Labor (DOL) has issued updated summary of benefits and coverage (SBC) templates, instructions, and related materials for use in completing SBCs, as required under the Affordable Care Act (ACA). Only minor changes have been made to the templates from the 2017 editions. The updated materials reflect the reduction to zero of the penalty for violating the ACA’s individual mandate. The majority of changes involve the coverage examples. As a reminder, SBCs are intended to provide a uniform and consistent summary to help plans and individuals better understand their health coverage and coverage options. An SBC must be provided to participants upon application, by the first day of coverage, within 90 days of a special enrollment period, upon contract renewal and upon request.
Plans and insurers will need to use the updated SBC templates and related documents for plan and policy years beginning on or after January 1, 2021. Additional SBC documents available on HHS’s website – which include an updated SBC calculator guide and narratives – also must be used on this timetable. All of the revised documents are available in five languages (English, Spanish, Chinese, Tagalog, and Navajo).
Should you have questions regarding this or any other area of health reform, contact your Conner Strong & Buckelew account representative toll-free at 1-877-861-3220. For a complete list of Legislative Updates issued by Conner Strong & Buckelew, visit our online Resource Center.