United Benefit Advisors Insight and Analysis Blog

A Summary of Benefits and Coverage (SBC) is four page (double-sided) communication required by the federal government. It must contain specific information, in a specific order, and with a minimum size type, about a group health benefit's coverage and limitations. If an employer providing an SBC is a covered entity under the Section 1557 of the Patient Protection and Affordable Care Act (ACA), additional requirements apply.

Topics: summary of benefits and coverage, SBC, ACA Section 1557, Affordable Care Act

Topics: summary of benefits and coverage, SBC, Group health plans, Danielle Capilla

1. IRS Provides Details on Reimbursing Premiums for Individual Health Coverage or Medicare Part B, Part D, for Medigap for Active Employees. For many years, employers were permitted to reimburse premiums paid for individual coverage on a tax-favored basis, however, these "employer payment plans" frequently are unable to meet all of the PPACA requirements. Read more

Topics: wellness, ACA, PPACA, IRS Reporting Rules, summary of benefits and coverage, Cadillac Tax, PPACA reporting, Medicare, UBA Health Plan Survey, Affordable Care Act

A Summary of Benefits and Coverage (SBC) is a four-page (double-sided) communication required by the federal government under the Patient Protection and Affordable Care Act (ACA). It must contain specific information, in a specific order and with a minimum size type, about a group health benefit's coverage and limitations. An SBC is required whenever application or open enrollment materials are provided to new hires or current employees. If no application or open enrollment materials are given, an SBC must be provided when the person can first enroll.

Topics: ACA, Open Enrollment, summary of benefits and coverage, SBC, group health insurance, Danielle Capilla

There is always something to be concerned about. Please read on.

Many have talked about the options for posting compliance documents online. It is interesting to note that posting documents on a company’s intranet is not enough. Especially in light of the new court decision (Thomas v. CIGNA Group Insurance, E.D.N.Y. (2013)), the topic is even more important. Historically, companies have mailed out hard copies of their compliance packets, Summary Plan Descriptions (SPDs), Summary of Benefits and Coverage (SBC), and Summary of Material Modifications (SMM). If this packet contains the Patient Protection and Affordable Care Act (PPACA) State Exchange notification, it also needs to go to new hires within 14 days.

Topics: PPACA Affordable Care Act, summary of benefits and coverage, Peter Freska, The LBL Group, Summary of Material Modifications, compliance documents, Summary Plan Description

By Carol Taylor, Employee Benefit Advisor
D&S Agency, a UBA Partner Firm 

Topics: PPACA, health insurance exchanges, employee wellness, retirement, health marketplace, small group employers, Group health plans, private insurance exchange, benefit communication, benefit consultants, benefit management, compliance with health care reform, employee health, group health insurance, healthcare consumerism, health plan compliance, health reimbursement account, insurance solutions, medical plan, self funded health plans, small business, dependents, dependent insurance, family insurance benefits, summary of benefits and coverage, SBC

By Carol Taylor, Employee Benefit Advisor
D&S Agency, A UBA Partner Firm

Topics: PPACA, health insurance exchanges, employee wellness, retirement, health marketplace, small group employers, Group health plans, private insurance exchange, benefit communication, benefit consultants, benefit management, compliance with health care reform, employee health, group health insurance, healthcare consumerism, health plan compliance, health reimbursement account, insurance solutions, medical plan, self funded health plans, small business, dependents, dependent insurance, family insurance benefits, summary of benefits and coverage, SBC

A Summary of Benefits and Coverage (SBC) must contain:

Topics: PPACA, health insurance exchanges, employee wellness, retirement, health marketplace, small group employers, Group health plans, private insurance exchange, benefit communication, benefit consultants, benefit management, compliance with health care reform, employee health, group health insurance, healthcare consumerism, health plan compliance, health reimbursement account, insurance solutions, medical plan, self funded health plans, small business, dependents, dependent insurance, family insurance benefits, summary of benefits and coverage, SBC