For many employers it is open enrollment season. That means it is time once again to distribute a Summary of Benefits and Coverage (SBC). We previously addressed the basic SBC requirements in two alerts issued in 2012 (available https://www.hitesmanlaw.com/client-alerts/alert_120716/ and https://www.hitesmanlaw.com/client-alerts/alert_120724/). In those alerts, we covered issues such as which plans must issue SBCs, who must provide the SBC and to whom it must be provided, distribution deadlines, distribution methods, and SBC content and format.
In April, 2016, the federal regulatory agencies issued new guidance regarding the SBC requirement (available here https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits). That guidance included a revised SBC template along with updated instructions and other materials. Insurance companies and plan sponsors are required to use the government-issued SBC template when preparing their SBCs.
Plan sponsors and insurers must generally begin using the new SBC template effective April 1, 2017. More specifically:
- For plans that offer an annual open enrollment period, the new SBC template must be used for any open enrollment period beginning on or after April 1, 2017.
- For plans that do not offer an annual open enrollment period, the new SBC template must be used for any plan year beginning on or after April 1, 2017.
An employer that sponsors a calendar year plan is not required to use the new SBC template for the 2017 plan year; it will begin using the new SBC template for the 2018 plan year. An employer that sponsors a non-calendar year plan may be required to use the new SBC template for the 2017 plan year depending on the date on which the open enrollment period or plan year begins.
Please contact us if you have questions or are in need of assistance with preparing or distributing SBCs.