From the Hotline: Providing Summary of Benefits & Coverage to Employees

Question: Do I need to provide employees who are not on the medical plan but eligible for our medical plan with a copy of the Summary of Benefits and Coverage?

Answer: It is our understanding that under the final SBC rules, you must provide a written SBC without charge to a participant or beneficiary with respect to each benefit package offered by the plan or issuer for which the participant or beneficiary is eligible, regardless of current participation.

The spirit and intent of this portion of the health care reform rules is to educate consumers about the health care options under their employers’ plans in preparation for their expanded health care choices that will become available in 2014 when exchanges are introduced.

For more detailed information about the SBC requirements, visit:
Short Version of the SBC rules with guidance for compliance: http://www.gpo.gov/fdsys/pkg/FR-2012-02-14/pdf/2012-3230.pdf
Full Federal Register version of SBC rules: http://www.gpo.gov/fdsys/pkg/FR-2012-02-14/pdf/2012-3228.pdf