Health & Welfare Plans Newsletter

BULLETIN
Supplement to
February 25, 2016

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[Official Guidance]

Text of Proposed New Template and Accompanying Materials for Summary of Benefits and Coverage
Posted for public comment; includes:

  1. Summary of Benefits and Coverage (SBC) Template [PDF] [MS Word]
  2. Sample Completed SBC [PDF] [MS Word]
  3. Instructions for Completing the SBC -- Group Health Plan Coverage
  4. Instructions for Completing the SBC -- Individual Health Insurance Coverage
  5. Why This Matters language for "Yes" Answers
  6. Why This Matters language for "No" Answers
  7. Proposed Guide for Coverage Examples Calculations -- Maternity Scenario, Diabetes Scenario, and Foot Fracture
  8. Proposed Coverage Examples Narrative -- Maternity Scenario
  9. Proposed Coverage Examples Narrative -- Diabetes Scenario
  10. Proposed Coverage Examples Narrative -- Foot Fracture
  11. Uniform Glossary of Coverage and Medical Terms
Comment request was filed today, and is scheduled to be published in the Federal Register tomorrow.

(Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL] and Center for Consumer Information & Insurance Oversight [CCIIO], Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

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