Understanding The Affordable Health Care Act

Understanding the Affordable Health Care Act

Summary of Benefits and Coverage (SBC) and Uniform Glossary

After September 23, 2012, health insurance providers and group health plans are required to provide consumers with a summary that details the plan’s benefits and coverage. This was created to help users get a better understanding of the Affordable Health Care Act so they may make better health insurance choices.

These new forms include:

The Summary of Benefits and Coverage, or SBC, which is a glossary of terms used in health insurance coverage, e.g. “deductible” and “copayment” that will help in understanding the Affordable Health Care

It is required that all insurance companies and group health plans use the same SBC form to help users compare the various health plans. This form also includes details that shows two medical situations and compares the best plan for each situation. Consumers have the right to receive the SBC form when shopping or enrolling in
coverage.  Consumers may also request a copy of the SBC from their insurance company or group healthcare plan to get a better understanding of the Affordable Health Care Act.

What This Means for You

Many consumers do not fully understand what they are buying when they shop for insurance. These new rules are a joint effort among many government health agencies, which include the Department of Health and Human Services. This easy-to-understand information about ACA health plan benefits and coverage allows users to make real comparisons among the available insurance options. The goal is to present more options to the insurance marketplace so that more than 180 million American workers that currently have private healthcare coverage will not only have more choices, but a better understanding.

Some Important Details

The ACA provision applies to all health plans, whether they are employer-sponsored or private, effective September 23, 2012.

The SBC must be presented to all who are shopping or enrolling in a health care plan, whether it is a new applicant or a renewal.

The coverage examples give a general sense of how a plan would cover situations like the  normal delivery of a baby, and services that aid in chronic ailments like  type 2 diabetes.

If you don’t speak English, you may be entitled to receive the SBC and uniform glossary in your native language upon request.