Nov. 22, 2017

SBC Updates for Small Groups

You may have recently retrieved a Summary of Benefits and Coverage (SBC) from the Standard SBC tool that describes an overview of what members’ plans cover and their level of cost sharing for those services. Updates have been processed and new versions of the documents are now available in the tool to retrieve.

Review the list of 2017 and 2018 changes below for more details on the updates, and always review the SBC for accuracy before distributing to members.

Year
Market Segment
Language
Plan ID
Change Made
2017
Small Group
English
Spanish
RS31 (with and without maternity)
The in-network out-of-pocket maximum amount was changed to $3,500 for an Individual and $10,500 for a family.

The out-of-network out-of-pocket maximum was changed to $7,000 for an individual and $21,000 for a family.
2017
2018
Small Group
English
Spanish
RSH2 (with and without maternity)
“Deductible" was removed from the “What is not included in the out-of-pocket limit?” answer on Page 1.
2017
2018
Small Group
English
Spanish
RS22
The in-network out-of-pocket limit amounts were changed to $3,000 for an individual and $9,000 for a family.

The out-of-network out-of-pocket amounts were changed to $6,000 for an individual and $18,000 for a family.