This video walks through the difference between an SBC (Summary of Benefits and Coverage) and an SPD (Summary Plan Description), both of which are important documents for health plan participants:

• SBC (Summary of Benefits and Coverage): Required by the Affordable Care Act for plans starting on or after September 23, 2012. It is a written document that outlines key details of a health plan, including definitions of coverage terms, coverage descriptions, cost-sharing requirements, limitations, and examples of coverage for common medical situations. It is designed to help employees understand their health plan and potential out-of-pocket costs.

• SPD (Summary Plan Description): Required by ERISA, the SPD is a disclosure document that explains what the plan offers and how it operates. It includes details on when employees can participate in the plan, how benefits are calculated, and how to file claims. The plan administrator must provide the SPD free of charge to participants and must also provide updates if the plan changes.

Understanding these documents is crucial for plan administrators, as they will frequently deal with both SBCs and SPDs.