Insurers Fail to Provide the Required SBC Documents

Last month, the Summary of Benefits and Coverage (SBC) provision of the PPACA law took effect and most issuers are still struggling to provide the documents. The Dept. of Labor has stated that, during the first year of applicability, it will not impose penalties on plans and insurers that are working diligently and in good faith to comply, according to a report by Tyurla.

The law states that insurance companies need to provide a paper SBC document within seven days of application, renewal, or first day of coverage. Generating SBCs for all of the plan designs a health insurance company offers is proving to be a challenging process. Tyrula visited the websites of more than 35 major health plans the week after the law took effect. Tyrula targeted individual plans and applied as a single male born in 1980 who doesn’t smoke. Tyrula found that 61.5% insurance companies did not have SBCs online. Manu Uppal, CEO and co-founder of Tyrula LLC, said, “It’s not surprising that a high percentage of health plans have not made their SBCs available online. Creating SBCs is not an easy task. An AHIP study from last year predicted $194 million in annual ongoing operating costs for all insurance plans to comply with the SBC regulation. Many companies may have taken a wait-and-see approach and are planning to be compliant by October 2013.” For more information, visit

Last Updated 05/25/2022

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