Summary of Benefits and Coverage (SBC)

Access information about your benefits and coverage

The Summary of Benefits and Coverage (SBC) is a document that all insurance companies are required to provide consumers as a result of health care reform. It is a standardized summary of health plan benefits and coverage, including covered benefits, cost sharing examples, and coverage limitations and exceptions.


Purpose of SBC

Provide individuals with standard information so they can compare medical plans as they make decisions about which plan to choose. Health insurers must provide the SBC to individuals:

  • When they enroll in coverage for the first time
  • Prior to the beginning of each new plan year
  • Within seven business days of a request

Requirements of SBC

The SBC must include a:

  • Four-page overview of plan benefits, cost sharing and limitations
  • Required set of coverage examples explaining how the plan works
  • Phone number and internet address for obtaining copies of plan documents

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