Summary of Benefits and Coverage (SBC)

An easy-to-read snapshot of the health plan’s costs, benefits, covered health care services, and other features.

The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered healthcare services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary. For more information about your coverage or to get a copy of the complete terms of coverage, [insert contact information]. For general definitions of common terms, such as allowed amount, balance billing, coinsurance, co-payment, deductible, provider, or other underlined terms, see the Glossary. You can view the Glossary at www.[insert].com or call 1-800-[insert] to request a copy.

Understanding which benefits are covered and how much different services cost is complicated. Insurance companies now provide a Summary of Benefits and Coverage for every health plan they offer. The Summary of Benefits and Coverage explains the health plan in easy-to-understand language. It includes consumer cost-sharing requirements and examples that illustrate the different benefits of the plan