Summary of Benefits and Coverage

Summary of Benefits and Coverage and Uniform Glossary Required Under the Affordable Care Act

OMB: 1210-0147

IC ID: 198888

Documents and Forms

Document Name Document Type
English_SBC-Template-Accessible-Format CLEAN.docx www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-SBC Template
sbc-instructions-for-completing-the-group-health-plan-coverage-new.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Instruction
sbc-uniform-glossary-of-coverage-and-medical-terms-new.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-SBC Sample Glossary
sbc-why-this-matters-language-for-yes-answers-new.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-SBC Yes Answers -- Why This Matters
sbc-why-this-matters-language-for-no-answers-new.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-SBC - No Answers - Why This Matters
Having-a-Baby-Guide-11-2019.xlsx www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-Template
Managing-Type-2-Diabetes-Guide-11-2019.xlsx www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-Template
Simple-Fracture-Guide-11-2019.xlsx www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-Template
Coverage-Examples-Calculator-Instructions-11-2019.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Instruction
Maternity-Care-Narrative-11-2019.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-Narrative
Diabetes-Narrative-11-2019.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-Narrative
Foot-Fracture-Narrative-11-2019.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-Narrative
SBC-Coverage-Examples-Calculator-Excel-11-2019.xlsm www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-Coverage Calculator
AIAN Limited Cost Sharing-11-2019-v2.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-AIAN Limited Cost Sharing
AIAN-Zero-Cost-Sharing-11-2019-v2.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-AIAN Zero Cost Sharing
Crosswalk-of-changes-11-2019.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-Crosswalk of Changes
Individual-Instructions-11-2019.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Instruction
List-of-Anchors-Updated-11-2019.xlsx www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-List of Anchors
English_Sample-Completed-SBC-Accessible-Format CLEAN.docx www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits Other-SBC Template (Completed)