Get Ready to Update Your Summary of Benefits and Coverage for 2017

June 10, 2016

The Centers for Medicare and Medicaid (CMS) recently issued the final 2017 Summary of Benefits and Coverage (SBC) template, group and individual market SBC instructions and uniform glossy of health coverage and medical terms. The new SBC must be used for plans with plan years beginning after April 1, 2017. In addition to the current coverage examples, which are diabetes care and childbirth, the new SBC requires a plan to address coverage for a foot fracture so the consumer understands what the plan covers in an emergency scenario. Additionally, the 2017 template expands the information about cost sharing and includes enhanced language to explain deductibles. Plans also must address individual and overall out-of-pocket limits in the new SBC template. Plan Administrators are advised to budget additional time and additional money to adjust to the new SBC template.

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