Summary of Benefits and Coverage and Uniform Glossary Requirement

Issued November 27, 2012

As part of the Affordable Care Act of 2010, health insurance carriers as well as group health plans and their administrators are now required to provide applicants, enrollees, beneficiaries, and participants with a Summary of Benefits and Coverage (SBC) and Uniform Glossary. The provision is applicable on the first day of the first open enrollment period on or after September 23, 2012.

The SBC is a summary of available health plans and must include topics such as covered benefits, cost-sharing requirements, limits on coverage, and excluded benefits. The Uniform Glossary provides a list of commonly used health coverage terms, such as deductible and copayment, with consistent definitions to help consumers better understand their health coverage options.