By : Susie Souza
Healthcare Reform Update
SUMMARY OF BENEFITS AND COVERAGE
The mandate became effective on September 23, 2012 and applies to all group and individual plans. What is the Summary of Benefits and Coverage? Under the Affordable Care Act (ACA), health insurers must provide a summary of benefits and coverage (SBC) to individuals plan applicants and members, and health insurers and employer groups must provide an SBC to participants and beneficiaries (generally employees and dependents). SBC's must follow standards set forth by the federal agencies. For individual plans, the SBC rules are effective September 23, 2012. Group Plans, the SBC rules have two different effective dates depending on whether the participant or beneficiary is enrolling or re-enrolling during an annual open enrollment period. If it's during an open enrollment period, the SBC rules are effective on the first day of the open enrollment period beginning on or after September 23, 2012. Note - That the relevant date is the first day of the open enrollment period, not the first day of plan year. If it's not during an open enrollment period (newly eligible individuals and special enrollees), the SBC rules are effective on the first day of the first plan year beginning on or after September 23, 2012.
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