NEW SBC TEMPLATE FOR PLAN YEARS BEGINNING JAN. 1, 2021
New SBC Template for Plan Years Beginning Jan. 1, 2021
The U.S. Department of Labor has issued a new Summary of Benefits and Coverage (SBC) template, instruction, and related materials for use beginning on the first day of the first open enrollment period for any plan/policy years that begin on or after Jan. 1, 2021, with respect to coverage for plan/policy years beginning on or after that date. You can access the new template here. Click here to see a sample of a completed SBC.
Minimum Essential Coverage Disclosure The release modifies the current SBC Template and Instructions to update the statement after the minimum essential coverage disclosure. The updated statement reads: Minimum Essential Coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, certain Medicare and Medicaid coverage, CHIP, TRICARE, and certain other coverage. If you are eligible for certain types of Minimum Essential Coverage, you may not be eligible for the premium tax credit. This statement was updated because, as of Jan. 1, 2019, the tax payment required by an individual for not maintaining minimum essential coverage (unless he/she had a coverage exemption) was reduced to zero.
Template and Instructions
The SBC Template and Instructions have also been updated to include an additional option for issuers completing the minimum value disclosure on the SBC. Because the concept of minimum value is not relevant with respect to individual market coverage, the 2021 SBC Template adds “Not Applicable” as a response option for the minimum value disclosure, and reads:
Does this plan meet the minimum value standards? [Yes/No/Not Applicable].
The 2021 Instructions indicate that issuers of individual market coverage should answer “Not Applicable.”
Other Changes:
- The update also adds the “Total Example Costs” for each of the three coverage examples to the template.
- The release also updates the versions of the calculator, guides, and narratives in a number of ways. A complete list of updates to the Calculator, Guide, and Narratives is available here.
Click here for help with completing the SBC.
Click here to view related FAQs.