Blue Cross and Blue Shield of Illinois

 

October 11, 2013

Legislative Update
Reminder: Summary of Benefits and Coverage Replaces Highlight Sheets for 2-150 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, easy-to-understand 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. The SBC 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.

Due to the ACA requirement, as of Oct. 1, 2013, Blue Cross and Blue Shield of Illinois (BCBSIL) has replaced the current highlight sheets with SBCs for all 2-150 groups. 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 further instructions on SBC customization, please refer to the updated training demo. We have provided a PDF copy of the training for your convenience. For quick reference, you can also view this buckslip

Please send any questions you may have regarding SBCs to your account representative.

This communication is intended for informational purposes only. It is not intended to provide, does not constitute, and cannot be relied upon as legal, tax or compliance advice. The information contained in this communication is subject to change based on future regulation and guidance.

 
 
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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.