Final regulations on summary of benefits and coverage (SBC) are available. Insurers, employers and administrators — pay close attention to these rules because they will apply to open enrollment that begins on or after September 23, 2012.

On August 22, 2011, the departments of Health and Human Services, Labor, and Treasury (the agencies) issued proposed regulations on the requirements for drafting and issuing SBCs and the uniform glossary that is required to be provided by plans as well.  

A summary of those proposed regulations are available here. 

On February 9, 2012, the agencies released final regulations on the requirements for drafting and issuing SBCs and the uniform glossary that is required to be provided by plans as well. The new rules take effect on April 16, 2012.   

The final regulations do not significantly modify the proposed regulations, and provide no flexibility or relief for large employer self‐insured plans despite a significant effort to get such relief.

Group health plans and issuers should pay close attention to the newly finalized SBC regulations because there is only a short amount of time to assemble necessary information, coordinate responsibilities between parties and prepare for distribution.

Failure to provide compliant SBCs could result in potential civil penalties for group health plans and health insurance issuers.

Groom Law Group, Chartered, is a Washington, D.C.-based law firm that focuses exclusively on employee benefits issues.