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Summary of Benefits and Coverage

Under the Affordable Care Act, health insurers and self-funded employers must provide a uniform Summary of Benefits and Coverage (SBC) to people who apply for and enroll in health policies.

Insurance companies and group health coverage must provide you with:

  • A short, plain-language Summary of Benefits and Coverage (SBC)
  • A Uniform Glossary of terms used in health coverage and medical care

This information allows you to make “apples-to-apples” comparisons when you’re looking at different coverage.

All individual and group health policies must use the same standard form to help you compare policies. The SBC also includes details, called coverage examples, which allow you to see what the policy would cover in two common medical situations: diabetes care and childbirth.

The SBC is available for every policy in the Connect For Health Colorado Marketplace. You’ll find a link to it on each policy page when you enroll through the website.

You can also ask for a copy from your insurance company or group health administrator at any time. All health policies must provide the SBC to you at important points in the enrollment process, like when you apply for or renew your policy. You can also ask for a copy of the Uniform Glossary to help you understand words used in health coverage and medical care.

 

For help in answering your personal questions, schedule a meeting today.

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Health Insurance
  • Understanding Your Health Insurance Options
  • Health Insurance Plans Available on the Marketplace
  • Essential Health Benefits
  • Summary of Benefits and Coverage
  • Preventive health services for adults
  • Pre-65 Health Care Insurance
  • Health Savings Accounts
  • Understanding the Affordable Care Act

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Mandatory Centers for Medicare & Medicaid Services (CMS) Disclaimer - "We do not offer every plan in your area. Currently, we represent 9 organizations which offer 108 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options." This is a solicitation for insurance consulting.

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