A Summary of Benefits and Coverage (SBC) and a standard glossary of health care terms are requirements for all health plans and both must be distributed to plan participants by insurance companies and employers. The idea is to make sure everyone gets understandable information about their health insurance.
With typical bureaucratic expertise HHS has issued instructions for completion of this form that rival … frankly I can’t think of an analogy that is appropriate. This administration is setting new standards for command and control the likes of which I have never seen in my fifty years dealing with employee benefit regulations.
Here are a couple of examples, you can draw your own conclusions as to the environment in which employers must operate. Aren’t you pleased to know there is now a Federal law determining font size? I added the bold text.
Form language and formatting must be precisely reproduced, unless instructions allow or instruct otherwise. Unless otherwise instructed, the plan or issuer must use 12-point (as required by Federal law) font, and replicate all symbols, formatting, bolding, and shading.
Cost Sharing Information Box:
• The first three bullets in the information box at the top of page 2 should be replicated with the same text, formatting, graphic, bolded words, and bullet points. Only the fourth bullet may change.
• The fourth bullet will change depending on the plan:
o For plans that use a network, the plan or issuer should fill in the blank on the fourth bullet of the template, using the terminology that the plan or issuer uses for “in-network” or “preferred provider”. This should be the same term as used in the heading of the first sub-column under the Your Cost column.
o For non-networked plans, the plan or issuer should delete the fourth bullet and replace it with: “Your cost sharing does not depend on whether a provider is in a network.”


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