News & Announcements

New FAQs Issued for ACA

Posted Tuesday, March 24, 2020 6:25 am

To help people understand the Affordable Care Act and benefit from it, the Department of Health and Human Services, Department of Labor, and the Treasury jointly prepared answers to various frequently asked questions from stakeholders.  The most recent FAQs address the summary of benefits and coverage (“SBC”) examples calculator, the Guide and Narratives for coverage examples, instructions for completing the SBC Template, and the SBC Template and associated materials, which were updated November 7, 2019, and can be found here.  According to the FAQs:

  • Group health plans and health insurance issuers of individual and group market coverage will be required to use these updated versions beginning on the first day of the first open enrollment period for any plan years that begin on or after January 1, 2021.

  • The calculator is a tool to generate the estimated out-of-pocket costs that a consumer can expect to pay under the plan or coverage for three hypothetical medical scenarios: maternity care, type II diabetes, and a simple foot fracture.  Use of the calculator is not required.
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