Overview of the SBC Final Regulations

        Final Rule Updates SBC Requirement


The 2015 regulations generally finalize the December 2014 proposed regulations without significant changes, which implement certain changes to the SBC requirement. Overall, the modifications in the final regulations:

     • Clarify when and how a plan or issuer must provide an SBC

     • Streamline the SBC template

     • Add certain elements to the SBC template that the Departments
     believe will be useful to consumers

In addition, the final regulations make some of the SBC enforcement safe harbors and transitions permanent, with several modifications.

On June 16, 2015, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) published final regulations on the summary of benefits and coverage (SBC) and uniform glossary requirement under the Affordable Care Act (ACA).

These regulations finalize provisions in proposed regulations that were published on Dec. 30, 2014, in order to amend prior final regulations from Feb. 14, 2012. According to the Departments, the changes made by these final regulations are designed to improve consumers’ access to important health plan information and to provide clarification that will make it easier for group health plans and health insurance issuers to comply with the SBC requirement.