September 27, 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 question addresses the Summary of Benefits and Coverage (SBC). Q. What is the process for creating an SBC for fully insured or ASO groups for a Jan. 1, 2014, effective date and beyond? A. By law, the insurer and the employer each have the independent responsibility of creating and distributing the SBC for fully insured health plans. The law makes it the employer’s responsibility to create and distribute the SBC for self-insured plans. The health insurer has no legal obligation to do so. Here is the process for each type of group: Fully Insured Groups Our approach to fully insured groups: |