- CMS released an updated summary of benefits and coverage template and uniform glossary from HHS, the Department of Labor, and the Department of the Treasury Wednesday.
- In addition to coverage examples for diabetes care and childbirth, the final 2017 version includes a coverage example for a simple fracture, according to CMS.
- Health plans and issuers must use the new SBC for the open enrollment period that begins on or after April 1, 2017.
Under the Affordable Care Act, insurers must provide people shopping for health plans with a brief summary of the coverage they offer and the individual’s cost-sharing responsibilities. The uniform glossary of health and coverage terms is meant to assist consumers in evaluating and comparing different SBCs.
In addition to the new coverage example, the revised template offers more information about deductibles and requires plans to explain individual and overall out-of-pocket caps in the SBC.
Aside from these changes, the major upgrade to the new SBC is that terms used in electronic SBCs can be hyperlinked to the uniform glossary, Health Affairs Blog reports. Moreover, individual terms are hyperlinked to their definitions, and plans can link to the glossary by hovering over a term.
According to CMS, the changes reflect input from the National Association of Insurance Commissioners and consumer groups. The final SBC template is largely unchanged from a draft version released in February.