What is the purpose of a summary of benefits and coverage (SBC)?

The purpose of a summary of benefits and coverage (SBC) is to provide consumers with standardized information about a health plan's coverage and costs. This document is designed to help individuals easily compare different health insurance options so they can make informed decisions about their healthcare.

The SBC includes crucial details such as what services are covered, the limitations and exceptions to those services, the cost-sharing aspects (like deductibles and copayments), the total out-of-pocket maximum, and any other essential features of the health plan. This standardization ensures that consumers receive the same type of information regardless of the insurer, making it easier to understand the features and benefits of different health plans.

While the claims process, listings of providers, and pricing for individual medical services are important aspects of health insurance, they are not the primary purpose of the SBC. The SBC focuses specifically on providing a clear and concise overview of coverage and costs, making it a critical tool for consumers navigating their health insurance options.