The Employee Benefits Security Administration (EBSA) is trying to get employers and their benefits advisors ready to issue summaries of benefits and coverage (SBCs) by the Sept. 23 compliance date.
The Patient Protection and Affordable Care Act of 2010 (PPACA) will require health insurers and employers to provide standardized, 4-page SBCs. The SBCs are supposed to help individuals and employers make apples-to-apples comparisons when they’re shopping for coverage.
The SBC would include a summary of basic plan features, along with coverage examples that show how a specific enrollee’s plan would work if the enrollee had a baby, were managing Type II diabetes, or were dealing with other common illnesses, chronic conditions or life events. Consumers would get SBCs when they apply for coverage or enroll in group plans. Consumers also could get SBCs upon request.
PPACA opponents are still trying to block PPACA with lawsuits, bills in Congress and regulatory maneuvers.
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Federal agencies have postponed compliance dates for other initiatives in the past and could do so for the SBC requirements.
Some critics have argued that the SBC requirements will be hard on small issuers and small plans, because the requirement that issuers and plans provide individualized SBCs means that many SBC providers will have to have systems capable of generating a huge number of SBCs in a relatively short period.