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Summary of Benefits and Coverage (SBC) Requirement Effective - September 23, 2012

The Summary of Benefits and Coverage Requirement within the Affordable Care Act (i.e., Obamacare) becomes effective September 23, 2012.  The ostensible purpose of the SBC requirement is to require that benefit information be passed to plan members in an easy to understand format and in a timely fashion.  However, without a doubt it creates an additional administrative burden upon carriers and employers administering group health plans.  

Fully insured plans will be the least effected because the carriers have the responsibility of producing the SBCs for these plans.  Self-funded plan sponsors are responsible for SBCs.  These sponsors are usually the employer and they will have to rely on their administrators to help them produce the required documentation.

United Healthcare has distributed an excellent guide to the SBC requirements for both fully insured and self insured plans.  We have linked it below for your convenience.  As always, we stand ready to assist you should you have any questions about this new regulation or any other regulations being implemented with the Affordable Care Act.


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