2025 Summaries of Benefits & Coverage (SBCs) Ready for Distribution

Under the terms of the federal Affordable Care Act, employers are responsible for providing employees with certain prescribed notices regarding their health insurance coverage.  For example, all employers offering health insurance benefits to their employees must provide employees with a Summary of Benefits and Coverage, or SBC. This SBC, which follows a standard format prescribed by the federal government, should be distributed to all benefits-eligible employees prior to the beginning of the plan’s open enrollment period each year.

The Health Trust’s open enrollment period will begin on November 15, 2024, and end on December 15, 2024, for a coverage effective date of January 1, 2025.  This means that SBCs must be distributed to all current benefits-eligible employees before November 15 in order to comply with the law.  SBCs must also be provided to any new benefits-eligible employees, so that they are able to review and compare benefits for any health plan(s) in which they are eligible to enroll.

The 2025 SBCs are now available on the Health Trust website, at https://www.mmeht.org/employer-resources/summaries-of-benefits-and-coverage/.

Please note that the Plans have been renamed for 2025.  This information was shared via a letter to all participating employers and members, and in a follow-up email to employers, in mid-September.  For more information on the plan names and other health plan changes for 2025, including a copy of the member letter, please refer to the news article on the Trust website here: https://www.mmeht.org/news/health-plan-changes-for-2025/.

It is important to note that employees must be provided with a copy of the SBC for each plan in which they are eligible to enroll.  So, for example, if employees can choose between the Acadia (formerly the POS C Plan) and the Baxter (formerly the PPO 500) plans, the employer must provide each benefits-eligible employee with the SBC for both plans (Acadia and Baxter).

SBCs may be provided to employees electronically (e.g., via e-mail), as long as certain requirements are met.  If an employee is able to access documents electronically at work, at a location where the employee is reasonably expected to perform his/her work duties, and as long as access to the employer’s electronic information system (e-mail, internet, etc.), is an integral part of the employee’s work duties, the notice may be provided electronically.

However, if there are employees who do not have access to computers at work, and for whom electronic access is not a regular integral part of their work responsibilities, notice must be provided in hard copy (paper) form, unless the employee requests otherwise.  In addition, even if an employee may be provided with an electronic version of the SBCs, if he or she requests a paper copy, you must provide it.

If you have any questions, please feel free to call the Health Trust at 1-800-852-8300.  Thank you.