Upon application - If a plan (including a self-insured group health plan) or an issuer distributes written application materials for enrollment, the SBC must be provided as part of those materials. For this purpose, written application materials include any forms or requests for information, in paper form or through a website or email, that must be completed for enrollment.
By first day of coverage - If there is any change in the information required to be in the SBC that was provided upon application and before the first day of coverage, the plan or issuer must update and provide a current SBC no later than the first day of coverage.
Special enrollment/enrollees - The SBC must be provided to special enrollees no later than the date on which a summary plan description is required to be provided (90 days from enrollment). A special enrollee is an eligible person who did not enroll during their open enrollment period, or a person who acquired a new dependent through marriage, birth or adoption.
Upon renewal - If a plan or issuer requires participants and beneficiaries to actively elect to maintain coverage during an open season, or provides them with the opportunity to change coverage options in an open season, the plan or issuer must provide the SBC at the same time it distributes open season materials.
Upon request - The SBC must be provided upon request for an SBC or summary information about the health coverage as soon as practicable but in no event later than seven business days following receipt of the request.
/resources/frequently-asked-questions