The new rules have been released regarding SBC and Uniform Glossary under national health care reform. These rules will help consumers receive clear and consistent information about their health plan coverage. Generally:
We continue to review the final regulations to determine how these requirements may impact our accounts and members. Read the full press release. You can also view the template for the SBC and the 
Uniform Glossary.
Our Summary of Benefits and Coverage Services
Beginning on or after September 23, 2012, Blue Cross Blue Shield of Massachusetts will create SBC's on behalf of self-funded and fully insured accounts upon renewal, application, request and when material changes occur.
| Account Type | Legal Requirements and Service |
| Self-Funded Accounts | The responsibility to create and distribute the SBC lies with the employer, plan sponsor, or plan administrator; however, we will create the SBC as a value-added service and provide a copy to the account. The account will be responsible for distributing the SBC to plan participants and beneficiaries. Translations will be available upon request. |
| Fully Insured Accounts | Under federal law, the insurer and the employer have an obligation to create and distribute the SBC to members. To prevent duplication, the law permits the insurer and fully insured account to enter into an agreement about each party's responsibilities. Again we will create the SBC as a value-added service and provide a copy to the account. The account will be responsible for distributing the SBC to plan participants and beneficiaries. Translations will be available upon request. |
What Does the Summary of Benefits and Coverage Include?
It will only include a description of benefits that we insure or administer for the account; it will not include any description of benefits that the account designates to another third-party insurer or administrator.
We will provide further information as it becomes available.
This information is provided for informational purposes only and does not constitute legal advice. Please consult your legal counsel regarding your specific situation.
Please note that this content is only intended to describe national health care reform requirements under the Patient Protection and Affordable Care Act (PPACA). It does not address Massachusetts law requirements or the potential impact of Massachusetts law on federal PPACA requirements.
For purposes of PPACA implementation, Blue Cross Blue Shield of Massachusetts assumes the plan year is the policy year, unless an account notifies us otherwise.
