New DOL Guidance on Summary of Benefits and Coverage (SBC)
The U.S. Departments of Labor, Health and Human Services, and the Treasury have recently issued new guidance to help health and welfare funds implement the new Summary of Benefits and Coverage ("SBC") required under the Patient Protection and Affordable Care Act ("PPACA"). The SBC is a four-page summary, which group health plans are required to provide to participants beginning with the first plan year on or after September 23, 2012. The FAQs about Affordable Care Act Implementation (Part IX), issued May 11, 2012, address when the SBC may be provided electronically and what electronic features they may include, circumstances that trigger an issuer to provide and SBC to an individual applying for coverage or to a group health plan shopping for coverage, combining SBC elements for side-by-side comparisons of different benefit packages, circumstances where penalties are imposed for failure to provide the SBC, an issuer’s obligation to provide an SBC for benefits it does not insure or no longer offers, and updates to the SBC template and related documents.
For more information about the Summary of Benefits and Coverage or other PPACA questions, please contact your Trust Fund counsel.
Author: Kristina Zinnen
