May an SBC be provided electronically?


Issue:

You are starting to plan for the distribution of the Summary of Benefits and Coverage (SBC) as the Patient Protection and Affordable Care Act requires. For group health plan coverage, may an SBC be provided electronically?

Answer:    

With respect to group health plan coverage, an SBC may be provided electronically: (1) by an issuer to a plan, and (2) by a plan or issuer to participants and beneficiaries who are eligible but not enrolled for coverage, if:

  • the format is readily accessible (such as in an html, MS Word, or pdf format);
  • the SBC is provided in paper form free of charge upon request; and
  • in a case in which the electronic form is an Internet posting, the plan or issuer timely notifies the individual in paper form (such as a postcard) or email that the documents are available on the Internet, provides the Internet address, and notifies the individual that the documents are available in paper form upon request.

An SBC also may be provided electronically by a plan or issuer to a participant or beneficiary who is covered under a plan in accordance with the Department of Labor's disclosure regulations. Those regulations include a safe harbor for disclosure through electronic media to participants who have the ability to effectively access documents furnished in electronic form at any location where the participant is reasonably expected to perform duties as an employee and with respect to whom access to the employer's or plan sponsor's electronic information system is an integral part of those duties. Under the safe harbor, other individuals also may opt into electronic delivery.

Online enrollment. In addition, SBCs may be provided electronically in connection with online enrollment or renewal and to participants and beneficiaries who request the SBC online, as long as individuals have the option to receive a paper copy. The electronic SBC can include some electronic features such as scrolling and expansion of columns, and it can be displayed on a single webpage.

Source: IRS Reg. §54.9815-2715(a)(4)(ii)(A) and (B).

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