The Department of Labor's Employee Benefits Security Administration recently updated its guidance for summary of benefits and coverage. As background, the Patient Protection and Affordable Care Act, as amended ("PPACA"), requires group health plans and health insurance issuers to provide a summary of benefits and coverage ("SBC") that "accurately describes the benefits and coverage" under a group health plan or insurance coverage. SBCs communicate certain coverage and benefit information to plans and plan participants in a uniform format not to exceed four double-sided pages. An SBC may be provided as a stand-alone document or as a part of the summary plan description. For additional background information, please refer to our prior informational article here.
The recent updated guidance includes a new SBC template authorized for the second year of applicability, as well as a completed sample template. The Frequently Asked Questions ("FAQs") page regarding implementation of various provisions of the PPACA has also been updated with new information, including additional guidance regarding SBCs. The FAQs are available online at The Affordable Care Act Implementation Part XIV.
The updated SBC templates are also available online:
- Template (authorized for second year of applicability) | MS Word Format
- Sample Completed SBC (authorized for second year of applicability) | MS Word Format
Fraser Stryker is a leader in employee benefits and tax law. Attorneys in the Firm's Employee Benefits Practice Group advise businesses, governments, and nonprofit/tax-exempt organizations on a wide variety of tax and employee benefits matters, transactions, and litigation. Fraser Stryker helps employers implement and maintain innovative and cost-effective employee benefit plans that attract and retain top talent. For more information, or if you would like to discuss the summary of benefits and coverage requirements, please contact Nicole R. Konen, or Emily Wischnowski.
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This article is provided by Fraser Stryker for general informational purposes and is not intended to be and should not be construed as legal advice on any specific facts or circumstances.
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