Policy Examples

• Under Section 2715 of the Public Health Service Act, created by the Affordable Care Act (ACA), health insurers and group health plans must provide clear, consistent and comparable information about health plan benefits and coverage to the millions of Americans with private health coverage. source
• A Summary of Benefits and Coverage (SBC) is an easy-to-read summary that lets consumers make apples-to-apples comparisons of costs and coverage between health plans. SBCs are federally required for all individual and employer-based health plans. This is the only document that provides information in a standard format across plan types. source
• A Summary Plan Description (SPD), a requirement of ERISA, is a written document administered to plan beneficiaries which includes information on what the plan provides and how it operates. If the plan changes, administrators must publish and distribute a revised SPD or amendment to all participants. source