![]() Coverage Examples Calculator Instructions (PDF) (PDF).Narrative for Simple Foot Fracture Scenario (PDF) (PDF).Narrative for Diabetes Scenario (PDF) (PDF).Narrative for Maternity Scenario (PDF) (PDF).Why This Matters language for SBC “No” Answers (for April 1, 2017).Why This Matters language for SBC “Yes” Answers (for April 1, 2017).Instructions for Completing the SBC – Individual Health Insurance Coverage (PDF) (PDF) (for April 1, 2017). ![]() Instructions for Completing the SBC – Group Health Plan Coverage (PDF) (PDF) (for April 1, 2017).For plans and issuers that do not use an annual open enrollment period, this SBC template and associated documents is required beginning on the first day of the first plan year (or, in the individual market, policy year) that begins on or after Apand before January 1, 2021. SBC Materials and Supporting Documents (Authorized for use prior to Janu)Īpplicability: Health plans and issuers that maintain an annual open enrollment period will be required to use the April, 2017 edition of the SBC template and associated documents beginning on the first day of the first open enrollment period that begins on or after Apwith respect to coverage for plan years (or, in the individual market, policy years) beginning on or after that date. Crosswalk of Changes (PDF) (describes updates made to the October 2019 version of the Coverage Examples Calculator).Coverage Examples Calculator (.12) (updated October 2019 for use on or after January 1, 2021).Coverage Examples Calculator Instructions (PDF).Narrative for Simple Foot Fracture Scenario (PDF).Guide for Coverage Examples Calculations – Simple Foot Fracture Scenario.Guide for Coverage Examples Calculations – Diabetes Scenario.Guide for Coverage Examples Calculations – Maternity Scenario.Why This Matters language for SBC “No” Answers (for January 1, 2021).Why This Matters language for SBC “Yes” Answers (for January 1, 2021).Instructions for Completing the SBC – Individual Health Insurance Coverage (PDF) (for January 1, 2021).Instructions for Completing the SBC – Group Health Plan Coverage (PDF) (for January 1, 2021).List of anchors (XLSX) for SBC Uniform Glossary terms on.Summary of Benefits and Coverage (SBC) Template.We corrected the errors and released remediated documents on February 3, 2020. NOTE: The Departments of Health and Human Services, Labor, and the Treasury identified minor errors in several of the 2021 SBC materials and supporting documents posted in November 2019, including the 2021 SBC Template. Summary of Benefits and Coverage and Uniform Glossary SBC Materials and Supporting Documents (Authorized for use for plan or policy years that begin on or after January 1, 2021)Īpplicability: Plans and issuers will be required to use the 2021 Summary of Benefits and Coverage (SBC), the 2021 SBC Calculator Guide and Narratives, and, should they choose to use the SBC Calculator, the 2021 SBC Calculator beginning on the first day of the first open enrollment period for any plan years (or, in the individual market, policy years) that begin on or after January 1, 2021, with respect to coverage for plan or policy years beginning on or after that date. ![]() Notice of Privacy Act Statement for Issuers in States without External Review Laws (PDF) (PDF – 20 KB)įederal Register Notice on External Review Model Notice of Final Internal Adverse Benefits Determination (PDF) (PDF – 265 KB) Model Notice of Final External Review Decision (PDF) (PDF – 101 KB) Model Notice of Adverse Benefits Determination (PDF) (PDF – 256 KB) Navigator Funding and Enrollment Data, PY 2016-2020 (XLSX) Summary of First Year Consumer Assistance Program Grant Data (PDF) (PDF - 442 KB) Partial Report on the Independent Dispute Resolution (IDR) Process: October 1 - December 31, 2022 (PDF)Ĭonsumer Support and Information Consumer Assistance Program Grants Initial Report on the Independent Dispute Resolution (IDR) Process: April 15 - September 30, 2022 (PDF) No Surprises Act Federal Independent Dispute Resolution
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