%%EOF h�b```�-,@2�A��2,@�����R �b�h~�O�=�^��3e���d�`����A�C�q;�M-��L�4#�:0�� ��Y�B��- �� 0 The SBC shows you how you and the plan would share the cost for covered health care services. endstream endobj 65 0 obj <. zpu�ch����ai��p�����M�#A���R�3��JghC�|�>�,���������(4+����\DQ�â�4�@��!S��G6J&:['�l�c��׍MjP��F�iQHf�z(ܮ\� ��O���Mލm��N8���&G��f�I!s^�;�y)��Em�^��]ժ(!�i!�t2,F��Ťx���"�Sbv6�W6f�Wk|jO=��l*�Y�޹b�E�(�줈��][�k+p]�݇O��. h�b``�b``Z��� ��ˀ 775 0 obj <> endobj The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. %%EOF Employers with insured plans should make sure the carrier is providing the correct version of the template. endstream endobj 28 0 obj <. �LD�5�8��/0�3�`h8���A���"^ 5Vo��^2��x���� �[��eXsX�1pv084�-g�X�� Learn more about the SBC. In addition, the federal government has compiled a glossary of common These materials are required to be used for plan years beginning on or after Jan. 1, 2021. Documents in Portable Document Format (PDF) require Adobe Acrobat Reader 5.0 or higher to view, download Adobe® Acrobat Reader. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This means that the updated template must be used for the 2021 plan year’s open enrollment period.The SBC is a concise document providing simple and consistent information about health plan benefits and coverage. To get a complete list of services we cover, call us and ask for the “Evidence of Coverage” or you can vie %PDF-1.5 %���� The SBC shows you how you and the plan would share the cost for covered health care services. 92 0 obj <>/Filter/FlateDecode/ID[<433434FB0ADB1745AA811B02222E58EC>]/Index[64 48]/Info 63 0 R/Length 131/Prev 1514342/Root 65 0 R/Size 112/Type/XRef/W[1 3 1]>>stream 27 0 obj <> endobj �74%��{I�3�®�'b�꺲�59����G��.7lE/�C�]��'?��z��O����� �PQ��*��.� �9 endstream endobj startxref /����dM������J�>��*ɱ�Zx��׺>Wab�o>�*`�H��]&�m0+��_{��yr�|D�:�{�@� 64 0 obj <> endobj Summary of Benefits January 1, 2020 – December 31, 2020 This booklet gives you a summary of what we cover and what you pay. 2020 summaries of benefits and coverage | Health Insurance for Employers, Groups, and Individuals & Families Summary of benefits and coverage The Summary of Benefits and Coverage (SBC) is a federally mandated document designed to allow "apples to apples" comparisons of health plan options. ��$.�d`bd�d100�K����@� �� + If you are unable to turn on JavaScript, we encourage you to contact your nearest branch location. Summary of Benefits and Coverage (SBC) Template | MS Word Format h�bbd``b`Z$��� �h$X�@�?�D� 6=KD�kA:��w$�`�.�Aba@�c&���d`bdX�e`����k� 5-N Provided by Evolution of Benefits Recently, the Departments of Labor (DOL) and Health and Human Services (HHS) issued an up dated template and related materials for the summary of benefits and coverage (SBC). The SBC is mandated under the Affordable Care Act (ACA) and is a four-page document template that all plans must provide to participants. 0 111 0 obj <>stream The SBC shows you how you and the plan would share the cost for covered health care services. The SBC is a concise document providing simple and consistent The SBC shows you how you and the plan would share the cost for covered health care services. The SBC is mandated under the Affordable Care Act (ACA) and is a four-page document template that all plans must provide to participants. Prior to the beginning of the 2021 plan year: Get financial, retirement, mortgage and insurance tips! Uniform Glossary of Coverage and Medical Terms; SBC and Uniform Glossary Translations - Chinese, Spanish, Tagalog, and Navajo; Summary of Benefits and Coverage (SBC) Templates, Instructions, and Related Materials – for plan years beginning on or after 4/1/17. NOTE: Information about the cost of this plan (called the premium) will be provided separately. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan.

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