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Release of Final Summary of Benefits and Coverage Template and Uniform Glossary

Effective April 1, 2017, health plans and issuers of individual health insurance must comply with the final Summary of Benefits and Coverage (SBC) Template and Uniform Glossary. Existing SBC templates will need to be modified to reflect the final template. Although the template itself is similar to that in use today, several changes make the information provided more user-friendly. The new SBC and uniform glossary must be distributed by the first day of a health plan’s open enrollment period that begins on or after April 1, 2017. Notable changes include:

  • Many terms that were defined in the template itself may now be hyperlinked to the uniform glossary.
  • A third coverage example has been added – treating a simple foot fracture in an emergency scenario.
  • More information about cost sharing, such as enhanced language to explain deductibles and a requirement that plans address individual and overall out-of-pocket limits, is included in the final template.

Additional information regarding the SBC and supporting materials is available here.

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