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Summary of Benefits and Coverage

insurance

Under the Affordable Care Act, health insurers and self-funded employers must provide a uniform Summary of Benefits and Coverage (SBC) to people who apply for and enroll in health policies.

Insurance companies and group health coverage must provide you with:

  • A short, plain-language Summary of Benefits and Coverage (SBC)
  • A Uniform Glossary of terms used in health coverage and medical care

This information allows you to make “apples-to-apples” comparisons when you’re looking at different coverage.

All individual and group health policies must use the same standard form to help you compare policies. The SBC also includes details, called coverage examples, which allow you to see what the policy would cover in two common medical situations: diabetes care and childbirth.

The SBC is available for every policy in the Health Insurance Marketplace .  You’ll find a link to it on each policy page when you enroll through the website.

You can also ask for a copy from your insurance company or group health administrator at any time. All health policies must provide the SBC to you at important points in the enrollment process, like when you apply for or renew your policy. You can also ask for a copy of the Uniform Glossary to help you understand words used in health coverage and medical care.

 

Attention: This website is operated by Benefinder and is not the Health Insurance Marketplace website. In offering this website, Benefinder is required to comply with all applicable federal laws, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website may not display all data on Qualified Health Plans being offered in your state through the Health Insurance Marketplace website. To see all available data on Qualified Health Plan options in your state, go to the Health Insurance Marketplace website at HealthCare.gov.”

Also you should visit the Health Insurance Marketplace website at HealthCare.gov if:

  • You want to select a catastrophic health plan.
  • You want to enroll members of your household in separate Qualified Health Plans.
  • The plans offered here don’t offer pediatric dental coverage and you want to choose a Qualified Health Plan that covers pediatric dental services or a separate dental plan with pediatric coverage. Pediatric dental services are an essential health benefit.