The Affordable Care Act (ACA) requires health plans and health insurance issuers to provide a Summary of Benefits and Coverage (SBC) to health plan applicants and enrollees. The SBC provides information about health plan benefits and coverage.

On March 31, 2015, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) issued a Frequently Asked Questions (FAQ) announcing their intention to issue final regulations on the SBC requirement in the near future. The FAQ notes the final rules are expected to apply in connection with:

• Coverage that would renew or begin on the first day of the first plan year (or policy year, in the individual market) that begins on or after Jan. 1, 2016; or
• Open enrollment periods that occur in the fall of 2015 for coverage beginning on or after Jan. 1, 2016.

Despite this effective date, the new template, instructions and uniform glossary are not expected to be finalized until January 2016. According to the Departments, this delay is necessary to allow for consumer testing and offer an opportunity for the public to provide further input before finalizing revisions to the SBC template and associated documents. The revised template and associated documents will apply to:

• Coverage that would renew or begin on the first day of the first plan year (or policy year, in the individual market) that begins on or after Jan. 1, 2017; or
• Open enrollment periods that occur in the fall of 2016 for coverage beginning on or after Jan. 1, 2017.

The FAQ guidance leaves uncertainty for employers with regard to their SBC documents. The changes included in the final regulations may require health plans to update their SBC documents before the new template is released.

The DOL’s current template for the SBC, along with instructions and sample language, is available on the DOL’s website. Until further guidance is issued, these documents continue to be authorized.