Watch for Group Benefits Program Summary of Benefits and Coverage Documents
Starting September 3, 2019, cooperatives will begin receiving a Message Center notification when 2020 summary of benefits and coverage (SBC) documents are available on the Employee Benefits website. You must distribute SBCs either with your annual enrollment materials or by November 1, 2019 (whichever is earlier).
The SBC is a required disclosure for your co-op’s NRECA medical, dental, and vision plans. It helps plan participants compare their group benefit plan coverage options to make coverage decisions during annual enrollment. It describes exclusions and cost-sharing, gives examples of certain covered services, and includes a glossary of commonly used health insurance terms. Although some examples or terms may not apply to your co-op’s plan, by law they must be included in the SBC, which cannot be modified.
The model SBC has not changed for 2020. You will receive a 2020 SBC for:
- All NRECA medical plans renewed or modeled for January, 2020 during annual renewal through the Benefit Plan Rating and Renewal feature;
- Stand-alone wellness programs (co-ops must update the wellness SBC with certain highlighted changes before distributing it); and
- NRECA dental and vision plans only when the co-op pays 100% of the employee’s premium (you won’t receive an SBC for the NRECA VSP Vision Plan).
If your co-op offers either health flexible spending accounts or 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
Timing, distribution and acknowledgement
Because the SBCs will be released as the proposals you submitted during annual renewal are approved and processed, 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 2020, 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 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.