Summary of Benefits and Coverage and Uniform Glossary

Under the Affordable Care Act, the Fund is required along with all health insurers and group health plans to provide clear, consistent and comparable information about their health plan benefits and coverage. Specifically, the regulations will ensure consumers have access to two forms that will help them understand and evaluate their health insurance choices. The forms include:

• An easy-to-understand summary of benefits and coverage
• A uniform glossary of terms commonly used in health insurance coverage 

Under the law, insurance companies and group health plans will provide members with a concise document detailing, in plain language, simple and consistent information about health plan benefits and coverage. This summary of benefits and coverage document will help members better understand the coverage they have. It will summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions. 

You can find your shop summary on the left in English and on the right in Spanish.

Thanks to the Affordable Care Act, members will also have a new resource to help them understand some of the most common but confusing jargon used in health insurance. A uniform glossary of terms commonly used in health insurance coverage such as “deductible” and “co-payment” will help members better understand their benefits.