The ACA requires health insurance providers and employers to provide the SBC document to potential and current health plan members.
The final regulations require that the SBC be provided in several instances:
The group master policy is the legal contract between your group and Prevea360 Health Plan. The policy – along with the group member certificate, the SBC, the employer application for group coverage form, the employee applications and any applicable riders, amendments and/or addendums – constitutes the entire policy between Prevea360 Health Plan and the employer group.
The first section of the policy contains a signature page that should be signed and returned after a new or revised GMP is sent to you. The coverage condition overview section contains provisions specific to your group. This is followed by the general provisions that apply to all groups.