2024 Pay or Play Affordability Percentage

New SBC Template Will Be Required For 2021 Plan Years

On November 8, 2019, the Department of Labor (DOL) and Health and Human Services (HHS) issued an updated template and related materials for the Summary of Benefits and Coverage (SBC).

The following updated materials must be used for plan years beginning on or after January 1, 2021:

  • SBC Template,
  • Uniform Glossary,
  • Sample Completed SBC,
  • Instructions for Completing the SBC,
  • ‘Why This Matters’ language for SBC,
  • Guide for Coverage Examples Calculations,
  • Coverage Examples Calculator.

What is the SBC?

The Affordable Care Act (ACA) requires both grandfathered and non-grandfathered health plans and health insurance issuers to provide an SBC to applicants and enrollees.

The SBC is a document that provides simple and consistent information about health plan benefits and coverage. It is intended to help consumers better understand their coverage and to make it easy to compare different options when shopping for new coverage.

Action Steps

Prior to the beginning of the 2021 plan year, self-funded sponsors should ensure that they are using the new SBC template. Employers with insured plans should also make sure the carrier is providing the correct version of the template.

For more information on the updated SBC template and related materials, see the DOL or HHS websites.

Click here for a detailed overview.

It is our goal to guide you through ongoing change. Questions? Contact the Creative Benefits Team at 866-306-0200 or email us at solutions@creativebenefitsinc.com.