Agencies Issue Guidance On Summary Of Benefits & Coverage

This is the 23rd in a series of WorkCite articles concerning the Patient Protection and Affordable Care Act and its companion bill, the Health Care and Education Reconciliation Act of 2010 (referred to collectively as the Act). This WorkCite contains a discussion of a proposed regulation that addresses the requirement that plan sponsors provide a Summary of Benefits and Coverage (SBC) to participants and beneficiaries of employer-sponsored group health plans. The SBC rules have extensive coverage: they apply to both insured and self-insured plans, grandfathered and non-grandfathered, plans, and even to plans that are not covered by ERISA. A similar requirement is imposed on health insurance issuers when they receive an application or information request from a plan sponsor.