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Agencies Propose Revised Summary of Benefits and Coverage Template
Health Affairs Link to more items from this source
[Guidance Overview]
Feb. 26, 2016

"The proposed revised template adopts many of the NAIC stakeholder group recommendations and is a distinct improvement over the original NPRM template. It includes a new question -- 'Are there services covered before you meet your deductible?' ... The proposed revised SBC tracks the NAIC stakeholder recommended format for the coverage examples, which is somewhat less misleading and confusing than the NPRM version. It focuses on cost-sharing parameters that would apply to services received for these conditions and on what consumers would spend in cost sharing for these services. Significantly, the coverage examples are to be calculated by plans that have wellness programs assuming that enrollees are not participating in the wellness program[.]"

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