Summary of Benefits and Coverage (SBC)
Under the Patient Protection and Affordable Care Act (ACA), group health plans and health insurance issuers offering group and individual health coverage must provide a summary of benefits and explanation of coverage document (SBC) to plan participants and beneficiaries (i.e. individuals and dependents) and individual certificate holders. This is a collaborative effort between the group health plans and health insurance issuers, where both entities may be liable for failing to distribute the SBCs to individuals and dependents and the ‘willful’ failure to do so can result in up to a $1,000 fine per enrollee for each failure.
Additionally, the plan and issuer are required to distribute a Uniform Glossary upon request.
To obtain an electronic copy of an Easy Choice Health Plan of New York summary of benefits and explanation of coverage document (SBC), please enter the applicable Plan Benefit ID. This information can be located on your renewal letter (for Benefits Administrators and Direct Policy Holders) or by contacting Easy Choice. You may also contact our Member Services department (for individuals and dependents) or Sales Support department (for group administrators, agents and brokers) at 1-866-747-8422 to obtain an SBC or Uniform Glossary free of charge in paper form or if you have any questions about the SBC or Uniform Glossary.
An important note about the Coverage Type and Coverage Period on your Easy Choice SBC:
- Your Easy Choice health benefits are the same when you change from single coverage to family coverage. This is called Coverage Type, and it is indicated on top of each page of your SBC. All Easy Choice health benefits are the same regardless of Coverage Type.
- Your Easy Choice Coverage Period is the benefit year established by when you started your coverage with Easy Choice. It may be a calendar year or it could be from May of this year until April of next year, for example. Your Easy Choice SBC is valid for the Coverage Period indicated on top of each page of your SBC.
- If you obtain an SBC from our website, you will notice these fields have been left intentionally blank. You can contact Easy Choice to obtain your Coverage Type and Coverage Period if you do not already know this information.
Providing the SBCs to Members who belong to Employer Groups and Associations
How Easy Choice Provides SBCs to Employer Groups and Associations
-IMPORTANT INFORMATION FOR GROUP HEALTH PLANS
How Easy Choice Provides SBCs to Direct Pay/Individual Policy Holders
What are the content requirements for an SBC?
Notice of Modification
Sample SBC completed by the Department of Health and Human Services
Partial SBCs for Group Health Plans
Translations of SBCs
Frequently Asked Questions about the Summary of Benefits
Last updated November 2012
Easy Choice Customer Services is available at 1-866-747-8422, Monday - Friday, 9AM - 5PM.
Easy Choice Health Plan of New York is a marketing name for Atlantis Health Plan, Inc.