Benefit Documents Explained

Summary of Benefits (SBC)

  • What is it? An SBC  is a summary about a medical health plan's benefits and coverage. It lists what the plan covers and what you pay for covered services. Insurance carriers are required to provide an SBC for any job-based health plan. All SBCs have the same format.
  • Where can I find it? SBCs may be included in your renewal packet, downloaded from your insurance carrier's website or requested from your broker.
  • When do I need it? Employees can download this to compare benefits before enrolling in a plan. After open enrollment, SBCs are available in the Medical Insurance app on the employee dashboard for reference throughout the year.
Plan Summary
  • What is it? Plan summaries are like SBCs because they also explain what an insurance plan covers and what you pay for covered services. However, unlike SBCs, plan summaries are not standardized and will look different for each carrier. These are used for dental, vision, group life, voluntary life, short term disability and long term disability plans.
  • Where can I find it? Plan summaries may be included in your renewal packet or requested from your broker.
  • When do I need it? Employees can download this to compare benefits before enrolling in a plan. After open enrollment, plan summaries can be found in the employee dashboard for reference throughout the year.
Rate Sheet
  • What is it? An Excel document, PDF, or other that lists the cost of an insurance plan.
  • Where can I find it? Rate sheets are typically included in renewal packets. For new plans, you can use the sold quote from the carrier.
Evidence of Insurability (EOI)
  • What is it? This can also be referred to as a Statement of Health. The majority of Life & Disability plans require employees to submit an EOI if they enroll in coverage above a certain amount (guaranteed issue), or if they enroll in the plan outside of open enrollment.
  • Where can I find it? EOIs can be requested from your insurance carrier, broker, or be downloaded from your insurance carrier's website.
Employer Contribution to Employee Premiums
  • What is it? Most often, this is an Excel sheet or PDF created by the benefits administrator or broker that lists the employee cost and the employer cost. Employer contribution can be defined as a percentage or dollar amount.

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