Watch for Group SBCs Starting on September 11
Starting September 11, 2018 your cooperative’s 2019 summary of benefits and coverage (SBC) notices will be available through the Message Center on the Employee Benefits website. You must distribute SBCs either with your annual enrollment materials or by November 1, 2018 (if earlier).
The SBC is a required notice for your co-op’s NRECA medical, dental, and vision plans. It is designed to help plan participants compare their group benefit plan coverage options. It describes exclusions and cost-sharing and gives examples of certain covered services. It also includes a glossary of terms often used in health insurance coverage. Remember that the SBC formatting and content can’t be modified. Some examples or terms may not apply to your co-op’s plan, but they must be included by law and cannot be changed.
You will receive an SBC for:
- All NRECA medical plans renewed for January 2019 during annual renewal through the Benefit Plan Rating and Renewal page;
- Stand-alone wellness programs. You must update the wellness SBC to indicate whether you sponsor a weight loss program and make the highlighted changes before distributing it; and
- NRECA dental and vision plans where the co-op pays 100% of the premium for the employee (you won’t receive an SBC for the NRECA VSP Vision Plan).
If your co-op offers health flexible spending accounts and health reimbursement arrangements, you must create your own SBC for these plans. Download the samples provided on the Employee Benefits website, update the highlighted sections to reflect your plan’s provisions, and distribute them. These models are only samples; please review them with your legal counsel before using them:
- Health flexible spending accounts (FSA), except when your co-op does not contribute to the FSA, provides a dollar-for-dollar match or contributes no more than $500
- Health reimbursement arrangements
New for 2019
The section of the SBC titled What is the out of pocket limit for this Plan? has been updated with details to help plan participants understand how their out of pocket limit is calculated. There are no required formatting changes for 2019.
Timing and distribution
SBCs will be released as the proposals you submitted during annual renewal are approved and processed. This means that your co-op may receive different SBCs over multiple days. Distribute the SBCs to all individuals eligible for the group plans you will offer, including your employees, retirees, directors, your retained attorney, surviving dependents and your COBRA plan participants by November 1 or, if earlier, with your annual enrollment materials.
In addition to current plan participants, during 2019, also give the SBC to:
- new enrollees at the time of first enrollment
- individuals with HIPAA special enrollments and
- employees who request a copy (within seven business days).
For complete information about your SBCs, including which plans receive them, when to distribute them to employees, and electronic distribution guidelines, review the Summary of Benefits and Coverage (SBC) page in the BA Guide on the Employee Benefits website. There you’ll also find a list of frequently asked questions about the content and format of the SBC.
Acknowledgement
Acknowledgement is the important final step in the distribution process. Fill out the acknowledgment form on the Employee Benefits website by November 1. Follow the link in the original SBC Message Center notification or go directly to the form on the Group Plan Documents page. You can acknowledge distributing SBCs for multiple plans in one step.
If you have any questions about distributing your SBCs, contact the benefits compliance team at 866.673.2299, option 7, or at group.compliance@nreca.coop.