HCR Update: Departments Issue FAQ on Summary of Benefits and Coverage Changes

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As part of Health Care Reform, each employer-sponsored plan must be accompanied by a Summary of Benefits and Coverage (SBC).

Health and Human Services, the US Treasury and the Department of Labor published Part XIV of their FAQs on the Affordable Care Act, focusing on revisions to the Summary of Benefits and Coverage (SBC) on Tuesday, April 23, 2013. Here are two primary changes that take effect for plan year starting on or after January 1, 2014:

  • A statement must be included indicated whether a plan provides minimum essential coverage (MEC)
  • A statement must be included answering whether the plan’s share of the total allowed costs of benefits meets applicable minimum value (MV) requirements (i.e. at least 60% of allowed charges for covered services, also known as bronze level coverage)

Plans may provide this information by either updating the SBCs or providing it in a cover letter. The SBC template has been updated as well.