Summary of Benefits and Coverage and Uniform Glossary Required Under the Affordable Care Act

Section 2715 of the PHS Act directs the Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury (collectively, the Departments), in consultation with the National Association of Insurance Commissioners (NAIC) and a working group comprised of stakeholders, to "develop standards for use by a group health plan and a health insurance issuer in compiling and providing to applicants, enrollees, and policyholders and certificate holders a summary of benefits and coverage explanation that accurately describes the benefits and coverage under the applicable plan or coverage. To implement these disclosure requirements, collection of information requests relate to the provision of the following: • Summary of benefits and coverage, which includes coverage examples. • A uniform glossary of health coverage and medical terms. • Notice of modifications.

The latest form for Summary of Benefits and Coverage and Uniform Glossary Required Under the Affordable Care Act expires 2022-05-31 and can be found here.

Summary of Benefits and Coverage

Federal Enterprise Architecture: Health - Consumer Health and Safety