Background and Introduction

Section 2715 of the Public Health Service Act (PHS Act), which was enacted as part of the Patient Protection and Affordable Care Act (also referred to as PPACA, the Affordable Care Act, or the ACA), requires health insurers and group health plans offering health care coverage to enrollees and beneficiaries in the plan to provide a “Summary of Benefits and Coverage” (SBC) and Uniform Glossary to insured individuals and plan enrollees. The purpose of the SBC is to ensure that individuals enrolled in these plans are able to receive a simple, easy-to-understand summary of the benefits and coverage available under their plan. The law required the Departments of Health and Human Services, Treasury, and Labor (together, the Departments) to issue standards that would have to be included in the SBC. 

On February 8, 2012, the Departments issued the SBC and Uniform Glossary final rule implementing section 2715 of the PHS Act.¹ The Departments also issued a separate corresponding document, Templates, Instructions, and Related Materials; and Guidance for Compliance. Both of these documents will be published in the Federal Register on February 14, 2012. Additional templates, guidance and related instructions for the SBC and uniform glossary are available on the Departments’ websites.²

Below is a summary of key provisions in the final rule. 

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