Blue Cross and Blue Shield of Illinois

 

August 30, 2013

Legislative Update
Summary of Benefits and Coverage Replacing Highlight Sheets for 2-150 Employer Groups

Under the Affordable Care Act (ACA), all health insurers and group health plans are required to provide consumers with a Summary of Benefits and Coverage (SBC). The SBC is a summary of the benefits and health coverage offered by a particular plan. The SBC is intended to provide clear, consistent descriptions that may make it easier for people to understand their health insurance coverage and for consumers to shop for and compare insurance plans.

The SBC is completed using a government-designed template, so the SBC is consistent across all health insurance plans and includes:

  • What is covered by the plan
  • What is not covered by the plan
  • Cost-sharing provisions and exclusions
  • Coverage examples
  • A website and phone number for customer service and obtaining more information

The items in the SBC just represent an overview of coverage; they are not an exhaustive list of what is covered or excluded. The full terms of coverage are located in the insurance policy.

Blue Cross and Blue Shield of Illinois (BCBSIL) will be replacing the current highlight sheets with SBCs as of Sept. 30, 2013, for all groups 2-150. BCBSIL will no longer manage or oversee the creation and administration of highlight sheets. As previously communicated, you will be able to retrieve an SBC using the new SBC tool to customize the Coverage Period and Coverage For sections. For instructions on SBC customization, please refer to the training materials.

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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.