United Benefit Advisors Insight and Analysis Blog

SBC Template and Required Addendums for Covered Entities under ACA Section 1557

Posted by: Danielle Capilla    Apr 20, 2017 11:54:46 AM

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.

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

Nondiscrimination Regulations Relating to Sex, Gender, Age, and More Finalized

Posted by: Danielle Capilla    Jun 2, 2016 10:00:00 AM

The Department of Health and Human Services (HHS) recently issued a final rule implementing Section 1557 of the Patient Protection and Affordable Care Act (ACA), which will take effect on July 18, 2016. If entities need to make changes to health insurance or group health plan benefit design as a result of this final rule, such provisions have an applicability date of the first day of the first plan year beginning on or after January 1, 2017.

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Topics: ACA, PPACA, Affordable Care Act, ACA Section 1557, nondiscrimination rules, diverse workforce

HHS Proposes First of Anticipated Nondiscrimination Regulations

Posted by: Danielle Capilla    Sep 22, 2015 11:28:00 AM

The Department of Health and Human Services (HHS) has issued the first of the anticipated nondiscrimination rules, which sets forth proposed regulations to implement Section 1557 of the Patient Protection and Affordable Care Act (ACA). Section 1557 provides that individuals shall not be excluded from participation, denied the benefits of, or subjected to discrimination under any health program or activity which receives federal financial assistance, on the basis of race, color, national origin, sex, age, or disability. The proposed regulations also apply to any program administered by an agency of the federal government or an entity established under Title I of the ACA. These applicable entities are "covered entities" and include a broad array of providers, employers, and facilities. State-based Marketplaces are covered as Title I entities, as are Federally-Facilitated Marketplaces.

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Topics: ACA, PPACA Affordable Care Act, Danielle Capilla, covered entities, ACA Section 1557, nondiscrimination rules