Zane Benefits Publishes New Information on Summary of Benefits and Coverage in 2014

New Information for Summary of Benefits and Coverage for 2014

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Park City, Utah (PRWEB) December 03, 2013

Today, Zane Benefits, the number one online small business health benefits solution, published new information on summary of benefits and coverage in 2014.

According to Zane Benefits’ website, with the end of the year approaching and new plan years starting, it's time again for many employers to distribute the Summary of Benefits and Coverage (SBC).

The SBC summarizes the key features of the health plan, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.

The requirement for plan or issuers to provide the SBC started last year. The SBC must be provided beginning on the first day of the first plan year that began on or after September 23, 2012.

Per HHS regulations, the SBC must be offered during the following events:

  • Upon open enrollment.
  • If there are any changes, by the first day of coverage.
  • Mid-year enrollees.
  • Upon renewal.
  • Upon request.

The SBC must contain specific information summarizing key features of the plan and coverage, including:

  • A description of the coverage
  • The exceptions, reductions, or limitations on coverage
  • The cost-sharing provisions of the coverage, including deductible, coinsurance, and copayment obligations
  • The renewability and continuation of coverage provisions
  • A coverage facts label or coverage examples
  • A statement that the SBC is only a summary and that the plan document, policy, or certificate of insurance should be consulted to determine the governing contractual provisions of the coverage
  • A contact number to call with questions and an Internet web address where a copy of the actual individual coverage policy or group certificate of coverage can be reviewed and obtained
  • An Internet address for obtaining a list of the network providers, an Internet address where an individual may find more information about the prescription drug coverage under the plan or coverage, and an Internet address where an individual may review the Uniform Glossary, and a disclosure that paper copies of the Uniform Glossary are available

The SBC is required for both grandfathered and non-grandfathered plans in the insured and self-funded market, as well as the individual market.

Click here to read the full article.

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About Zane Benefits
Zane Benefits was founded in 2006 to provide a revolutionized SaaS (Software-as-a-Service) administration platform ("ZaneHealth") for defined contribution health care. The flagship software provides a 100% paperless administration experience to small businesses and insurance professionals that want to offer better health benefits without a traditional group health insurance plan at lower costs. For more information about Zane Benefits, visit http://www.zanebenefits.com.


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