The U.S. Department of Labor (DOL) has issued additional guidance on the summaries of benefits and coverage (SBCs) that the Affordable Care Act will require many health plan sponsors to distribute as early as this fall.

The guidance primarily takes the form of a new set of FAQs (frequently asked questions and answers) that supplements the FAQs that we discussed in a legal alert issued in March.

The new FAQs address a variety of subjects, including:

  • Additional safe harbors for furnishing the SBCs electronically
  • Transitional assistance that may help plan sponsors comply with the SBC requirements in certain situations (for example, where benefits are carved out among different carriers/administrators and plans for expatriates)
  • Transitional assistance for providing examples (through the use of a government-prescribed calculator that is in development)
  • Reaffirmation that those who act diligently and in good faith will not be subject to penalties for failures in the first year
  • The availability of translations of the SBC template into other languages and notice (in translation) of the availability of non-English-language services

The DOL has also revised the template SBC and the sample completed SBC to include notice of the availability of non-English-language services (in the four pertinent languages), correct a typographical error in the examples, and make certain formatting changes.

As the federal health care reform effort gained steam, Ballard Spahr attorneys launched the Health Care Reform Initiative to monitor and analyze legislative developments. With federal health care reform now a reality, our attorneys are assisting health care entities and employers in understanding the relevant changes and planning for the future. If you have questions regarding the contents of this legal alert, contact Edward I. Leeds at 215.864.8419 or leeds@ballardspahr.com, Clifford J. Schoner at 215.864.8626 or schonerc@ballardspahr.com, or the Ballard Spahr attorney with whom you work.


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