Today, the Departments of Treasury, Labor and Health and Human Services released guidance and final regulations under PPACA regarding the issuance of Summary of Benefits and Coverage (SBC). This guidance covers only the initial year of applicability.

The requirements to provide an SBC, apply for disclosures to participants and beneficiaries who enroll or re-enroll in group health coverage through an open enrollment period (including re-enrollees and late enrollees) beginning on the first day of the first open enrollment period that begins on or after September 23, 2012.

The sample notices do not provide language related to minimum essential coverage and whether the plan’s or coverage’s share of the total allowed costs of benefits provided under the plan or coverage meets applicable minimum value requirements since these regulations are yet to be fully defined and finalized.

The Departments intend to issue updated materials for later years. They recognize that, beginning January 1, 2014, new market reforms will take effect, which are expected to prompt additional changes to the SBC.

To view the Legislative Brief, click the following link:
Health Care Reform Summary of Benefits and Coverage Feb 2012

To view the template for the Summary of Benefits and Coverage and the glossary, visit: http://cciio.cms.gov/resources/other/index.html#sbcug

To view the Final Rule, visit: http://www.ofr.gov/inspection.aspx

For more information on the rules announced today, visit: http://www.healthcare.gov/news/factsheets/2011/08/labels08172011a.html