What is a Summary of Benefits and Coverage?

A Summary of Benefits and Coverage (SBC) is a standardized document required by the Affordable Care Act that explains health plan benefits in simple, consistent language. The SBC uses a uniform format to describe covered services, cost-sharing requirements, coverage limitations, and examples of how the plan would cover common medical scenarios. All health plans must provide this document to help consumers compare options.

Why summaries of benefits and coverage matter

• Standardizes plan information: Makes it easier to compare different insurance options
• Simplifies complex terms: Uses plain language to explain coverage details
• Illustrates real costs: Provides coverage examples for common medical situations

How Solace can help

A Solace advocate can help you interpret SBC documents, compare multiple plans side-by-side, and understand how specific benefits apply to your healthcare needs. Advocates can also help identify important coverage details that may not be immediately apparent in the summary.