Employers Summary of Benefits and Coverage Deadline Extended
By: Mary Thompson, Capstone Brokerage President, March 22, 2016
Good news for some employers dreading the reporting of Summary of Benefits and Coverage (SBC) to their employees. The Department of Labor recently extended the deadline. The benefit summaries will not have to be distributed until the first day of the first plan year that begins on or after April 1, 2017.
What does this mean for Employers?
Well, since the majority of employers have plans that start on January 1st, it means that they will now have until January of 2018 to distribute the Summary of benefits to employees. This will allow plenty of time for the administrators to make changes to current Summary of Benefits. For many this will come as a relief to the HR department as many of our clients and companies nationwide have been scrambling to meet the original March 28, 2016 deadline.
What is the Summary of Benefits and Coverage statement?
The Summary of Benefits and Coverage statement is a document will be available to employers when they are shopping for healthcare coverage as part of the employee benefits package provided by the employer. Under the Affordable Care Act, healthcare benefits must be presented to employees in simple language explaining the coverage and giving details about the coverage features.
What needs to be included in the Summary of Benefit Coverage Statement?
The Department of Labor has not issued the final rules and guidelines for the document; however, some of the current rules will still be applicable. The SBC will have to offer examples of how the coverage applies in specific situations. Particularly, it is required to provide examples of coverage in the event of a birth of a child and managing Type 2 diabetes. It should be noted that a change from the current rules will include the requirement to detail how coverage will be applied in a third party situation.
The examples will need to breakdown simple costs of treatment. In addition, the employer is also required to produce a summary for every plan that the employees are being offered and are eligible for. This summary should be in an online format to view the comparisons with ease.
What should the Summary of Benefits and Coverage form look like?
The Department Of Labor has provided sample templates on their website that will help both employers and insurers to start the process of creating the forms tailored to the coverage they are providing their employees. Visit the Department of Labor for examples as well as instruction for completing the Summary of Benefits forms.
A knowledgeable insurance broker will be able to further assist with any questions a business may have. It is important to maintain a relationship with your Benefits Broker. As always, our dedicated staff is here to answer any additional questions regarding the Summary of Benefits and Coverage forms.
