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
Entities such as employers with group health plans that
provide prescription drug coverage to individuals that are eligible
for Medicare Part D have two major disclosure requirements that
they must meet at least annually.
On February 17, 2017, the Department of Health and Human
Services’ Centers for Medicare & Medicaid Services (CMS) issued
a proposed rule to stabilize the health insurance market and
address risks to the individual and small group markets.
Under the Patient Protection and Affordable Care Act (ACA),
individuals are required to have health insurance while applicable
large employers (ALEs) are required to offer health benefits to
their full-time employees.
On December 20, 2016, the Department of Labor, Department of
Health and Human Services, and the Treasury issued FAQs About
Affordable Care Act Implementation Part 35. The FAQ covers a new
HIPAA special enrollment period, an update on women’s preventive
services that must be covered, and clarifying information on
qualifying small employer health reimbursement arrangements.
In addition to offering health benefits to employees, many
employers choose to extend benefits to non-employees, such as 1099
contractors, leased or temporary employees, members of a board of
directors, shared employees, interns, and more.