Giving Consumers a Picture of Health Insurance Costs & Benefits

Thanks to the health care law, starting today, millions of consumers will have access to a new consumer-friendly summary to help them understand their health insurance and compare health coverage options. This new tool, called the Summary of Benefits and Coverage�or SBC�has a uniform format that shows you basic information about your health insurance plan and how much it costs. The SBC also includes a new comparison tool, called Coverage Examples, that shows you what your insurance would cover in two common medical situations�having a baby and managing type 2 diabetes.

Health insurance issuers and group health plans must also provide access to a glossary of common terms (PDF 139KB) used in health insurance, such as �copayment� and �deductible,� with easy-to-understand definitions. And�for the first time�consumers who want to take a deeper dive into a particular plan or policy will be able to review the full contract outlining the benefits and limitations�before they sign up for coverage.�

The SBC will help consumers make informed choices based on critical information. For example, the Coverage Examples concept is modeled on the Nutrition Facts label�that rectangle on packaged foods with calories and grams of fat�that we now rely on when trying to make healthy choices for ourselves and our families at the grocery store.�

Coverage Examples showing what your insurance would cover.

Starting today, consumers can review SBCs for many individual market plans which are posted on the Plan Finder�, here on HealthCare.gov (Click on �Find Insurance Options�). �In addition, health plans and health insurance issuers must give you the SBC at certain times during the plan or policy year, including when you purchase coverage and when coverage renews.� Also, consumers can always get an SBC from a plan or issuer by requesting it.

The health insurance marketplace can be confusing for consumers.� The SBC will help explain benefits and costs in plain language and in a uniform and recognizable format so consumers can see how a particular plan works in terms they understand.� In addition, the SBC will not contain any �fine print� or insurance jargon. Instead, you�ll get the basic facts. And when we make the insurance marketplace more transparent and competitive, we empower consumers and help drive costs down.

Remember�Before you enroll, take control. The SBC can help you find a health insurance option that is best for you.

You can learn more information on today�s announcement here.

For a sample SBC, please visit this page (PDF 530KB).

For the SBC template, please visit this page (PDF 475 KB).