Health insurers and employers are required to provide members and potential customers with a new standardized Summary of Benefits and Coverage (SBC) to help them compare health plans, prices, and benefits. The SBC was designed to help consumers make apples-to-apples comparisons of all available healthcare options in the same way food labels give us standardized nutrition information about the foods we buy. Content and formatting requirements for the SBC are strict and used industry-wide throughout the U.S.
The SBC uses plain language, consistent terminology, and common examples to explain health plan benefits and coverage. It summarizes the key features of a plan, such as the benefits that are covered, the amounts you must pay, and any coverage limitations and exceptions. It also includes several examples of how a certain treatment or health condition would be covered under the plan.
In addition to the SBC, you’ll still receive a full benefit handbook for the health plan you choose. The SBC for your plan can typically be found on your health insurer’s online member portal. Or you can request a paper copy from your health insurer.