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Final Templates Released for Summary of Benefits and Coverage, and Uniform Glossary

The final templates for the Summary of Benefits and Coverage, and Uniform Glossary, were released by the Departments of Labor (DOL) and Health and Human Services (HHS) on April 6, 2016. As a reminder, these enhanced templates must be used during open enrollment for plans that begin on or after April 1, 2017.

 

How does the final SBC template differ from the one in use today?

The SBC template has been updated to include a coverage example for a foot fracture to show members what a plan will cover in an emergency situation. The updated template also includes additional information regarding cost sharing; for example, further explanation of deductibles and a requirement that plans address individual and overall out-of-pocket limits in the SBC. 

In addition, the template is now 2 ½ double-sided pages (five single-sided pages), rather than the previous four double-sided pages (eight single-sided pages). 

 

When must these final templates be used?

It will be required to use these documents for the first plan year beginning on or after April 1, 2017.* This means plans that begin in April 2017 or after will need to make sure their SBCs comply with the final regulations prior to their open enrollment period.

 

*On March 11, 2016, the DOL extended the applicability date from the first plan year on or after January 1, 2017, to April 1, 2017.

 

Where can I view the final templates?

The final documents can be viewed here:

 

 

If you have any questions, please contact your client solutions team.