Blue Cross and Blue Shield of Illinois

 

 

June 14, 2013

Legislative Update
Affordable Care Act Question of the Week: Summary of Benefits and Coverage

The “Question of the Week” answers frequently asked questions regarding the Affordable Care Act (ACA). This week’s questions address the Summary of Benefits and Coverage (SBC). If you have a general question about an ACA provision, contact your account representative.

Q. When do we expect the SBCs for 2014 to be available?
A.  Blue Cross and Blue Shield of Illinois received the information from the U.S. Department of Health & Human Services on April 23 regarding the updates to the SBC template. We are working on the updates and will provide information as soon as the SBCs are available.

Q. If employer groups put their SBCs on their websites for participants and beneficiaries, does that satisfy their obligation to provide the SBC? Do they also need to email the SBC to each participant and beneficiary to satisfy the law? Does this rule apply for open enrollment?
A. Posting the SBC on a company website without notifying the employees may not be sufficient to satisfy the obligation to provide an SBC to each participant and beneficiary. This applies to enrollment or renewal.  

The SBC may be provided electronically if:

  1. The format is readily accessible.
  2. The SBC is provided in paper form free of charge upon request within seven days.
  3. The employer notifies its employees via a paper form (such as a postcard) or email that the documents are available on its website.
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A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association.