Advance Notice of Benefit Changes
Effective September 23, 2012, if any mid-year material modifications in health plan coverage, such as increases in cost-sharing or benefit reductions, are made that are not reflected in the most recently distributed Summary of Benefits and Coverage (SBC ), the plan sponsor must send notice of the changes to plan participants at least 60 days before the modifications become effective. During open enrollment, plans and issuers must provide an updated SBC in accordance with the requirements otherwise applicable to SBCs, but do not have to provide a separate notice 60-days in advance of plan changes that take effect at renewal.
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Hot Topics
- If plan changes are made at the time of renewal, is a 60-day advance notice prior to the beginning of the next plan year required?
The final regulations provide that during open enrollment, plans and issuers must provide an updated SBC in accordance with the requirements otherwise applicable to SBCs, but do not have to provide a separate notice 60-days in advance of plan changes that take effect at renewal.
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Additional Resources
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Summary of Benefits and Coverage (SBC)
An NAIC-developed template.
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Uniform Glossary
An NAIC-developed draft of common health plan definitions.
- Sample Completed SBC Template
- Yes Answers
- No Answers
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American Fidelity Assurance Company does not provide tax or legal advice.
ESB-953(0212)