|2012 SBC Requirements
The new health care reform laws continue to be implemented and the proposed requirement for SBC's (Summary of Benefits and Coverage) are set to go into effect March 23, 2012.
So what are SBC's? How and why are they used? What are the requirements for employer sponsored plans?
We have outlined the answers to these and other FAQ's below.
- What is the purpose of an SBC? To provide clear, consistent, and comparable information to participants about their health plan benefits and coverage.
- What is included in the SBC? Specifically Standardized plan comparison tools, Summary of Benefits page, Glossary of Terms commonly used, and other pertinent plan information. The idea of the SBC is to provide consumers with a snap shot look at benefit details to enable them to make a cost-benefit analysis before purchasing coverage.
- What are the notification requirements for employers? SBC's must be provided to a consumer prior to enrolling in coverage and 30 days prior to reissuance or renewal. Participants enrolled in the health plan must be notified of any plan changes or the terms and conditions of benefits reflected in the SBC at least 60 days prior to the effective date of the change.
The proposed template of the new SBC format has been released and we expect to see more detail to these requirements in the near future. We will continue to keep you informed as we receive more information on these requirements in the next few months.
|60 Day Advance Notice
The 60 day advance notice requirement is just as it sounds, the requirement to notify employees of any cost or coverage changes to their current benefits within 60 days of the change.
This is a big change for not only employer groups but also the insurance carriers. For many large employer groups they are used to completing the renewal process several months in advance but for small and mid-size companies this becomes very difficult to administer.
Although this requirement is supposed to be effective March 23rd, the final regulations have not been published so we wait anxiously to see how this is going to be implemented. Our hope is that once the final requirements are set they give insurance carriers and employer groups enough time to adequately meet this requirement.