What is uniform glossary?
What is uniform glossary?
The Uniform Glossary is a document that is prepared for consumers and plan members and owned by the Department of Health and Human Services, Department of Labor and the Internal Revenue Service as part of the requirements of the Patient Protection and Affordable Care Act.
What is an SBC in healthcare?
An easy-to-read summary that lets you make apples-to-apples comparisons of costs and coverage between health plans. You can compare options based on price, benefits, and other features that may be important to you.
Who must receive an SBC?
The insurance company is required to provide the SBC to the sponsor of the plan (which is in most cases the employer) no later than 7 business days after the plan sponsor applies for the group policy, or requests information about coverage provided under the group policy.
What is included in a summary of benefits and coverage?
The SBC is a snapshot of a health plan’s costs, benefits, covered health care services, and other features that are important to consumers. SBCs also explain health plans’ unique features like cost sharing rules and include significant limits and exceptions to coverage in easy-to- understand terms.
What is the difference between coverage and benefits?
An insurance plan is designed to reimburse you for a loss. In an insurance plan, the insurer carries the risk. A benefit plan, on the other hand, is only set up to cover certain costs. Your dental benefit plan will only cover some procedures fully, and then pays a percentage of other procedures.
How do I get Kaiser summary of benefits and coverage?
You can provide SBCs in either a paper or electronic format. To download an SBC, please visit kp.org/sbc and select your region and plan. For additional information, download the Glossary of Health Coverage and Medical Terms (PDF) and the Q&As (PDF).
How do I find my SBC?
Where to find your plan’s SBC
- You’ll find a link to the SBC on each plan page when you preview plans and prices. You’ll also see the link when you’ve finished your application and are comparing plans.
- You can ask for a copy from your insurance company or employer at any time.
When must SBC be provided?
The SBC must be provided within 90 days after an individual enrolls due to a special enrollment event. When an employee requests an SBC, it must be provided within seven business days. Information may be provided in either paper or electronic format.
What is an SOB in insurance?
A Schedule of Benefits (SOB – but not that SOB) is a document that outlines the fees associated with each type of health care service covered by your plan. This includes: Your deductible and out-of-pocket max amounts.
What is full medical coverage?
Full coverage usually means you can receive whatever treatment you need that’s offered by your healthcare provider. Basic coverage is usually restricted to limited preventive care and check-ups, and some emergency services.
