The Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury have announced enhancements to the Summary of Benefits and Coverage (SBC) template and uniform glossary. The changes include an additional coverage example and language and terms meant to improve consumers’ understanding of their health coverage.
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Under the Affordable Care Act, issuers and health plans are required to provide a brief summary of what the plan covers and the cost sharing responsibility of the consumer, in order to help individuals make more informed choices among health plan options and better understand their coverage. Plans and issuers are also required to provide a comprehensive uniform glossary of commonly used health coverage and medical terms.
The SBC includes coverage examples that demonstrate the cost-sharing amounts an individual might be responsible for in three common medical situations.