Support through your toughest HR challenges: A network of 285,000 HR professionals.
Shawn Premer shows how doing the right thing for employees leads to positive business results.
Is your employee handbook keeping up with the changing world of work? With SHRM's Employee Handbook Builder get peace of mind that your handbook is up-to-date.
Build competencies, establish credibility and advance your career—while earning PDCs—at SHRM Seminars in 12 cities across the U.S. this spring.
#SHRM18 will expand your perspective – on your organization, on your career, and on the way you approach HR. Join us in Chicago June 17-20, 2018
Members may download one copy of our sample forms and templates for your personal use within your organization. Please note that all such forms and policies should be reviewed by your legal counsel for compliance with applicable law, and should be modified to suit your organization’s culture, industry, and practices. Neither members nor non-members may reproduce such samples in any other way (e.g., to republish in a book or use for a commercial purpose) without SHRM’s permission. To request permission for specific items, click on the “reuse permissions” button on the page where you find the item.
Update: Final Rule Issued on Benefit SummariesOn Feb. 9, 2012, the Obama administration issued afinal rule requiring U.S. health insurers and group health plans to provide a concise and comprehensible Summary of Benefits and Coverage document to current and potential health plan participants, for plan years beginning after the fall 2012 open enrollment season. See the
SHRM Online article
Administration Issues Final Rule on Summary of Benefits and Coverage.
Three federal agencies
announced in November 2011 via an online frequently asked question (FAQ) response that they will
notrequire sponsors of group health plans to comply with the requirement to create and distribute to employees a uniform Summary of Benefits and Coverage (SBC) and Uniform Glossary beginning March 23, 2012, as they had originally proposed.
The U.S. departments of Labor, Treasury, and Health aned Human Services, the agencies responsible for implementing the Patient Protection and Affordable Care Act (PPACA), said that compliance with the SBC requirement will not be required until the agencies publish a final rule with a new applicability date providing sufficient time for group health plans to comply.
The PPACA amended the Public Health Service Act (PHS Act), adding section 2715 to
require health insurers and group health plans to provide consumers with "clear, consistent and comparable information" about their health plan benefits and coverage.On Aug. 22, 2011, the departments issued
proposed rule and
template in connection with implementation of the SBC and uniform glossary requirements (see the
SHRM Online article "Proposed Rule Issued on Comparable Health Plan Summaries"). An applicability date “beginning March 23, 2012” was proposed. At the same time, the departments invited comments on a range of issues, including the timing of the application of the SBC requirement.
The departments received many critical comments on the proposed regulations and template (see the
SHRM Online article "Proposed Health Benefit Summaries Called Onerous"). The departments said they
intend to issue, "as soon as possible, a final rule that takes into account these comments and other stakeholder feedback."
"Many plan sponsors expressed concern that the SBC was not appropriate for self-insured group health plans," according to a Sibson Consulting
alert on the department's announcement. "Plan sponsors requested revisions to the form or a customized version for self-insured plans. Sponsors also commented that the SBC effective date should be delayed until some period of time after the final rules are published," the alert stated.
According to the departments' announcement, "until final regulations are issued and applicable, plans and issuers are not required to comply with PHS Act section 2715." The announcement added, "It is anticipated that the departments’ final regulations, once issued, will include an applicability date that gives group health plans and health insurance issuers sufficient time to comply."
A Reprieve Gives More Time to Prepare
According to an
alert from Sibson Consulting, although the SBC compliance deadline is no longer March 23, 2012, plan sponsors who want to get ready to prepare the SBC should:
Identifywhich plans must provide an SBC and for which benefit packages. Sponsors of fully insured plans should discuss with their insurer who will provide the SBC to plan participants and beneficiaries and when.
Reviewexisting plan documents, summary plan descriptions and other documents (such as Summaries of Material Modifications) to determine whether plan benefits are properly documented in those materials so that they can be easily transferred into a new SBC format.
Update plan documentsand summary plan descriptions to reflect plan changes required by the health care reform law.
is an online editor/manager for SHRM.
Health Care Reform Resource Page
Sign up for SHRM’s free
Compensation & Benefits e-newsletter
You have successfully saved this page as a bookmark.
Please confirm that you want to proceed with deleting bookmark.
You have successfully removed bookmark.
Please log in as a SHRM member before saving bookmarks.
Please sign in as a SHRM member before saving bookmarks.
Please purchase a SHRM membership before saving bookmarks.
An error has occurred
Recommended for you
SHRM Annual Conference & Exposition
SHRM’s HR Vendor Directory contains over 3,200 companies