SBCs for renewing small groups

August 11, 2015

We want to make you aware of a new regulatory interpretation related to the issuance of transitional (formerly called grandmothered) small group SBCs. Carriers are required to provide a Summary of Benefits and Coverage (SBC) to the employer 30 days in advance of the group’s renewal date. 

  • Transitional groups will receive an SBC for their current transitional plan(s) as well as an SBC for the similar ACA plan(s). 
  • Small groups on ACA plans will receive only the SBC for the plan(s) similar to their current coverage. 

We recognize that these documents can be confusing for your clients. SBCs for renewals effective June 1, 2015 were sent in May, and the July groups were sent their SBCs in early June. If you receive calls about the SBCs, please assist your client in identifying the appropriate SBC(s) to distribute to their employees.  If your client has not yet selected their plan(s), please retain these documents until their decision has been made. 

Transitional small groups can choose to keep their current plan or move to an ACA plan.  If your group selects an ACA plan for which they have not received an SBC, we will provide the SBC when we receive confirmation of their plan selections.

We are working to provide your small group renewals 90 days in advance of the effective date.  If you are able to notify us of your client’s decision early we will make every effort to see that they only receive the SBC(s) that are relevant to their plan selection. 

Questions? Please contact your account manager at 877-245-4077.