Summary of Benefits and Coverage

A Summary of Benefits and Coverage (SBC) is a requirement of the Patient Protection and Affordable Care Act which mandates that health insurance issuers and group health plans provide customers with a clear and... more +
A Summary of Benefits and Coverage (SBC) is a requirement of the Patient Protection and Affordable Care Act which mandates that health insurance issuers and group health plans provide customers with a clear and simple statement of the benefits and coverage of a particular health plan. A compliant SBC must include: 1) a short, plain language summary of a plan's benefits and coverage; and 2) a uniform glossary of terms commonly found in health insurance plans. less -
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New Health Care Reform FAQs, Part I

The DOL, HHS, and IRS (the “Departments”) recently released new Health Care Reform Frequently Asked Questions (“FAQs”). The FAQs provide guidance on updated DOL model notices, Health FSA carryovers, and summary of benefits...more

Employers, Remember Your SBC and New Template!

Employers conducting their annual group health plan open enrollments this fall must remember to include a summary of benefits and coverage (SBC), along with a uniform glossary to that SBC, as required by the Affordable Care...more

Health Reform… HIPAA… So Many Rules, What’s an Employer to Do? (Between Now and January 2014… A Lot!) - Increasing Compliance...

Employers face increasing compliance obligations over the coming year under various federal laws, including the Affordable Care Act (“ACA”), commonly known as the health reform law, and the privacy and security provisions of...more

Additional Guidance Issued on Summary of Benefits and Coverage Disclosure Requirements

The U.S. Departments of Labor, Health and Human Services, and the Treasury recently issued new guidance and templates regarding the summary of benefits and coverage requirement under the Patient Protection and Affordable Care...more

Agencies Issue Updated Summary of Benefits and Coverage

On April 23rd, the DOL, HHS and IRS (the “Agencies”) released an updated template for the Summary of Benefits and Coverage (“SBC”) that group health plans and issuers are required to send to plan participants....more

Affordable Care Act: New Requirements for Summary of Benefits and Coverage

The Departments of Labor, Treasury, and Health & Human Services have issued new guidance on the content requirements for health plan summaries of benefits and coverage (“SBCs”). Plan sponsors should ensure that the SBCs...more

More Guidance Issued on Summaries of Benefits and Coverage

The U.S. Department of Labor has issued a set of frequently asked questions, together with a new template, for the Summary of Benefits and Coverage (SBC) that applies to group health plans and individual health insurance. The...more

Health Care Reform Blog: SBC Form Revised/New FAQs Released

Earlier this week the Agencies issued a revised Summary of Benefits & Coverage (“SBC”) template for use in describing health plan coverage that begins on or after January 1, 2014 and before January 1, 2015. ...more

What Employers Need to Know About Healthcare Reform for 2013

As the end of 2012 approaches, we consider what a notable year it has been for the future of healthcare reform, starting with the United States Supreme Court’s decision to uphold key provisions of the Patient Protection and...more

2013 and 2014 under the Affordable Care Act

With the close of 2012 approaching fast, employers should consider the following checklist of items as the nation moves ahead with compliance with the Affordable Care Act. Effective in 2013: The following list...more

Group Health Plans: Year-End Action Items, Upcoming Changes, New Guidance

As 2012 closes, group health plan sponsors turn their attention to completing 2012 tasks, implementing upcoming 2013 changes, and preparing for the full impact of ACA in 2014. As 2012 draws to an end, employers pass...more

New Credits for Commercial and Industrial Ratepayers to Take Effect in January 2013

Starting on January 1, 2013, New Jersey commercial and industrial (C&I) ratepayers will be eligible for a new credit against their Societal Benefits Charge (SBC) contributions. The credit was signed into law by New Jersey...more

What Every Employer Should Know About the Affordable Care Act (ACA)

After months of uncertainty, the U.S. Supreme Court upheld the federal healthcare reform law known as the Affordable Care Act (ACA). What does this landmark law mean for employers now and in the near and distant future?...more

What Employers Need to Know for 2012 and 2013 Under the Patient Protection and Affordable Care Act

With the end of 2012 quickly approaching, and for 2013 planning purposes, this newsletter provides a high-level list of the important changes to be aware of under the Patient Protection and Affordable Care Act and the...more

EMPLOYEE BENEFITS ALERT: Deadlines loom for 2012 health care reform compliance by Jim Prince

While the timeline for health care reform calls for a phasing in of its key initiatives and compliance measures over several years, employers who provide health plan benefits — and particularly those who offer open enrollment...more

Health Care Reform Update: Are You Ready To Distribute Your SBCs?

Let's Talk About Health Care Reform: Are You Ready to Distribute Summaries of Benefits and Coverage (SBCs)? Suppose that health insurance policies were written in standard format using common terminology and that it...more

End of Year Action Items – Plan Now for 2012-2013 Compliance

With year-end fast approaching, now is the time for plan sponsors to review their employee benefit plans to ensure that they have been updated for any changes in the law, that required notices have been distributed, and to...more

Reminder: Upcoming Health Care Reform Deadlines

Under the health care reform enacted in 2010 under the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (referred to collectively here as “PPACA”) new obligations are...more

Benefits Update, No. 3, August 2012: Timeline Of Health Insurance Reform

As everyone knows, the Patient Protection and Affordable Care Act was upheld in a somewhat surprising Supreme Court decision last month. (For a recap of the decision see our Legal Alert on the case). Set out below is a...more

Timeline Of Health Insurance Reform

Excerpt from Health Insurance Reform Timeline chart: - W2 inclusion of cost of employer-sponsored health coverage for employers who filed more than 250 Forms W2 in prior year. 2012 Forms W2, due 1/31/13 -...more

Health Care Reform Upheld—Now What for Employers?

This summer, the U.S. Supreme Court upheld the individual mandate under the Affordable Care Act (to see our National eAuthority on the ruling, click here). So what does this mean for employers? The most important thing...more

Health Care Reform Update: Supreme Court Ruling Mandates Timely Employer Actions

The Supreme Court’s decision in National Federation of Independent Business v. Sibelius upholding the Patient Protection and Affordable Care Act (PPACA) leaves in place the market reforms and tax provisions that have become...more

Supreme Court Upholds Healthcare Reform - It's Time for Employers To Get To Work

Today the U.S. Supreme Court issued its long-awaited decision on the Patient Protection and Affordable Care Act (ACA). In what is easily the most significant decision this term, and arguably one of the most important rulings...more

Legal Alert: FAQs Issued on SBC Requirement

Executive Summary: The Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury recently issued an additional guidance providing answers to frequently asked questions (FAQs) regarding the implementation...more

Agencies Issue FAQs on SBC Requirements

The tri-agency task force has released new FAQs on the rules requiring group health plans and health insurers to issue Summaries of Benefits and Coverage (SBCs) under the Patient Protection and Affordable Care Act (PPACA)....more

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