Distribute Summary of Benefits and Coverage (SBC)

Group health plans and health insurers

For groups that conduct open enrollment, this is to be provided annually with your open enrollment materials.

For groups that do not conduct open enrollment, this is to be provided 30 days prior to the start of the plan year

Of note, the SBC must also be provided to special enrollees within 90 days of enrollment and within 7 business days of a request from a participant or beneficiary.

No filing requirement.

Plan participants and beneficiaries

• Plans must provide a summary of plan benefits, coverage and cost-sharing arrangements, including exceptions, reductions, limitations and continuation of coverage information.
• The summary may not exceed four double-sided pages
• This notice must be provided in addition to all other notices
  • SPD
  • Summary of Material Modifications (SMM)
  • Summary of Material Reduction in Covered Services/Benefits (SMR)

The Department of Labor has assembled resources to assist in meeting this requirement, include Microsoft Word templates. Please note, these templates reflect the new requirements for 2021 and must be used for any plan year beginning on or after January 1, 2021.