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2017 Summary of Benefits and Coverage Template Effective April 1

March 7, 2017

In March 2016, the Departments of Labor, Health and Human Services (HHS) and the Treasury  released the FAQs About Affordable Care Act Implementation (Part 30), providing the applicability dates and details for the new 2017 Summary of Benefits and Coverage (SBC) template and uniform glossary. All group and individual health insurance plans and policies are required to provide an accurate SBC to applicants, enrollees, policyholders and certificate holders. These updated templates are required for:

  • Plans and policies with an open enrollment period beginning on the first day of the first open enrollment period that begins on or after April 1, 2017, for coverage effective on or after that date; or
  • Plans and policies with no open enrollment period beginning on the first day of the first plan or policy year that begins on or after April 1, 2017.

SBCs sent during open enrollments prior to April 1 may still follow the old format.

Overview of 2017 SBC Template Changes:

  • Three coverage examples, including new simple fracture example
  • New calculator
  • Whether services are covered before the deductible
  • Whether the plan has embedded or non-embedded deductibles or out-of-pocket limits

For more information, please reference the UnitedHealthcare Large Group SBC Employer Guide or contact your UnitedHealthcare representative.