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 Effective September 23, 2012, the Affordable Care Act (or health care reform law) requires that all insurers provide SBCs (summary of benefits & coverage) to consumers when:

◦ They are shopping for coverage.

◦ Their coverage changes.

◦ Their deductible resets.

◦ It is requested by an enrolled policyholder.

(This requirement does not apply to “closed plans” which are plans or products that the insurer is no longer selling.)

An SBC is a concise summary of the key benefits and coverage provided through a health plan and the costs to the participant. It also provides lists of excluded services and other significant conditions or limitations. The mandate was initiated to help provide customers with a consistent description of benefits for all insurance plans offered in the marketplace.

You may receive your SBC in the mail, but more likely you will be notified electronically where it can be accessed.  If you are covered on an individual plan you should receive notification at your first renewal after September 23, 2012.  If you are covered on an employer plan you should receive notification from your HR department at your first renewal after September 23, 2012.  If you are an employer or HR contact you should forward the information you receive from the insurer to all employees currently on the plan, on COBRA coverage or those eligible for coverage in the future.  If you have questions about this please do not hesitate to call our office for details.