Summary of Benefits and Coverage (SBC)
PPACA requires initial SBCs to be distributed during the open enrollment period that begins on or after September 23, 2012. If your employee benefits include a Self-funded Medical Plan, you are required to complete an SBC for each benefit plan that you offer. In addition to your health plans, if you offer a Flexible Spending Account or Health Reimbursement Account, you may also be required to comply with these regulations. You are encouraged to discuss this requirement with your legal counsel.
What is an SBC?
It is a standardized summary of health benefits that makes it easier for individuals to compare coverage options, understand their health insurance benefits and what they will pay, and make informed decisions about which health plan to choose.
The information provided must be replicated using the exact wording, format, and layout dictated by the Department of Health and Human Services (HHS). Non-compliance may result in fines of up to $1,000 per day per enrollee for each failure to comply.
How EBS-RMSCO can help
Given the complexity of the rules and the potential for hefty penalties, it is vitally important that SBCs comply with the regulations set forth by the HHS. Simply fill out this form and let EBS-RMSCO help you comply with these requirements.