To: Participating Employers in the King County Bar Association
Re: Distributing SBCs (Summary of Benefits and Coverage) to Your Eligible Employees
IMPORTANT! ACTION REQUIRED. Read and Keep this Notice
The health care reform law (the Affordable Care Act) requires a new document, called the Summary of Benefits and Coverage ("SBC"), to be distributed to your eligible employees and their eligible dependents.
IMPORTANT: New and renewing Employers should download the appropriate SBC(s) for their applicable plan(s) on the Association’s website: www.kcba.org and distribute the SBC to their employees accordingly, as specified below. Follow these instructions to find the SBC(s): Click on Member Benefits under the Membership tab and click on the Quick Link named Insurance Services. Click on the Wells Fargo Insurance Services option and click on the Medical Section. Scroll down to the bottom of the page and print out the appropriate SBC.
Please note, if an employee’s eligible dependent does not live with the employee, you must also provide the SBC separately to that dependent.
When to Provide the SBC, and to Whom
- Open enrollment: When you renew your participation in the Association’s medical insurance each year and you permit your eligible employees to enroll or re-enroll in medical benefits, or add or drop medical coverage for dependents in open enrollment. At open enrollment you must include the current SBC in the open enrollment materials you distribute to your eligible employees. You must provide the SBC to your employees on or before the day written application materials are distributed to your employees.
- Initial Enrollment: When you hire an eligible employee, or a current employee becomes a member of an eligible class of employees, you must include the current SBC with the initial enrollment materials you give to the employee.
- Special Enrollment: When an employee or dependent becomes enrolled through a special enrollment, you must provide the SBC to the employee within 90 days after the employee or dependent becomes enrolled in the Plan.
- Request by Employee or Dependent: You must provide the current SBC to any employee or dependent who requests it. You must provide the SBC within 7 business days after the request.
Glossary of Health Coverage and Medical Terms
The Glossary of Health Coverage and Medical Terms is a related document to the SBC. It is located on the Association’s website underneath the SBC(s). You must provide a hard copy of the glossary upon request within seven business days following the date of the request.
Penalties for Failing to Provide the SBC
A Government penalty of up to $1,000 per enrollee applies for each "willful failure" to provide the SBC. In addition, failure to provide the SBC may result in an excise tax of $100 per day per individual for each day you fail to comply with the distribution requirements for that individual.
This notification is a general description of SBC distribution timing requirements applicable to insured health benefits under the Affordable Care Act. It is neither an exhaustive list nor a comprehensive discussion of all of the SBC requirements. Please consult your legal counsel for advice concerning the application of the SBC requirements to your plan. Information on the SBC and Glossary of Health Coverage and Medical Terms (Uniform Glossary) also can be found on the Department of Licensing’s Affordable Care Act site at http://www.dol.gov/ebsa/healthreform/index.html.
Group Health Options Plan Summary
Group Health Cooperative Plan Summary
Group Health Alliant Plus Plan Summary
Glossary of Medical and Health Terms