The federal government has issued a new format for the Summary of Benefits and Coverage (SBC) document effective April 1, 2017.
While the change has been made to improve readability for consumers, the new format may cause some confusion for readers. Given that, here are a few points of clarification.
One of the most significant changes to the format is the way deductibles are referenced in the cost-sharing chart. The cost-sharing chart shows copayments and coinsurance after the deductible has been met. For example, if labs go toward the deductible and then there are no charges, because the chart is showing cost after the deductible, the “What You Will Pay” column states “no charge.”
A new statement appears at the top of the chart noting that all copayments and coinsurance are after the deductible has been met, if a deductible applies (see chart below). Please note that while this wording appears at the top of the chart, it does not also appear within the chart for specific benefits on our deductible plan SBCs, nor is it repeated on the top of every page.
To Inquire, Review, or Discuss Any Updates Addressed on this Page
Source: HR 360, Inc.
All rights reserved