Provide an SBC within 7 business days of a participant request or special enrollment.
A revised SBC or SMM must go out at least 60 days before a material mid-year change.
Complete any carrier attestation, typically tied to renewal, and keep a copy.
| Trigger / Event | Timing | Who Sends | Notes |
|---|---|---|---|
| Annual open enrollment | With OE materials, before enrollment deadline | Carrier/TPA or Employer | Provide an SBC for each plan option offered, not just the one the employee selects. |
| New hire / initial eligibility | With enrollment/onboarding materials; no later than 7 business days after application received | Carrier/TPA or Employer | Include in benefit packets; log delivery date and method. |
| Special enrollment | No later than 7 business days after receiving the special enrollment request | Carrier/TPA or Employer | Applies to qualifying life events. Log request date, plan options sent, and delivery method. |
| Upon request | Within 7 business days of the request | Plan/Issuer | Any participant or beneficiary may request at any time. Log request date and response date. |
| Material mid-year modification | No later than 60 days before effective date | Plan/Issuer | A revised SBC or Summary of Material Modifications must go out in advance. Document the advance delivery date. |
| Annual carrier attestation (if required) | Per carrier's deadline, typically tied to renewal | Employer / Broker | Confirm to the carrier who distributed SBCs, by what method, and when. Keep a copy of the completed attestation. |
- Current SBC PDFs for each plan option: Obtain from your carrier (fully-insured) or confirm your TPA has them ready (self-funded). Confirm you have the current version, including any language versions required for your workforce.
- Eligibility/enrollment roster: All employees (and beneficiaries at different addresses) who need an SBC, and the planned delivery method for each group.
- Distribution log template: Fields for participant name, plan option, delivery date, delivery method, and (for requests) the request date. A spreadsheet works fine.
- Carrier/TPA attestation form or portal link: Check whether your carrier requires an annual confirmation and, if so, what format and deadline they use.
- Electronic delivery: HRIS assignment, email with a direct SBC link, or intranet/portal post. Use clear subject lines that make the SBC easy to identify. Maintain delivery reports or read logs as your proof.
- Paper delivery: Include SBCs in OE packets and new-hire benefit kits. Keep distribution lists or signed acknowledgments.
- Free paper copy on request: Regardless of your primary delivery method, any participant may request a paper copy at no charge. Include instructions in your electronic delivery on how to make that request.
- Dependents and beneficiaries: Spouses and dependents at a different address than the participant may be entitled to a separate SBC. Keep proof of address and delivery method for those households.
- Language access: SBCs must include taglines in any non-English language spoken by 10% or more of the county population where the plan operates, directing participants to translation assistance. Confirm your carrier's SBC reflects the September 2025 CLAS tagline updates.
- Distribution logParticipant name, plan option(s), delivery date, and method for each SBC provided.
- Copies of each SBC version distributedLabeled with plan year and effective date.
- Carrier/TPA attestation confirmationsOr portal screenshots showing your submission.
- Electronic delivery confirmationsRead receipts, HRIS completion reports, or portal logs.
- Requests logDate of each participant request and date/method of your response (to show the 7-business-day turnaround).
- Material modification noticesWith documentation showing 60-day advance delivery was met.
Common traps
FAQs
What is "SBC monitoring" versus "providing the SBC"?
Providing the SBC is the legal requirement to distribute the document to participants at specific trigger times. SBC monitoring is your internal tracking, and any carrier attestation, that those distributions happened correctly. This page covers the monitoring side; the underlying SBC distribution obligation is a related but separate compliance task.
Our carrier doesn't ask for an attestation. Do we still need to track?
Yes. Keep distribution logs regardless of whether your carrier requires confirmation. You need the records to respond to audits, participant requests, and any questions about whether SBCs were provided on time.
Do dependents and spouses get their own SBC?
A participant and beneficiaries at the same address can receive one copy. Beneficiaries at a different address are entitled to their own. Keep records of address and delivery method for those households.
- DOL: Summary of Benefits and Coverage, Employer Overview: DOL's main SBC page for employers, including FAQs, template links, and guidance documents.
- CMS: SBC Templates & Resources: All current SBC template files, the Uniform Glossary, and translated versions (updated September 2025).
- 29 CFR 2590.715-2715: DOL's governing regulation covering all SBC timing, format, and delivery requirements.
- 45 CFR 147.200: The parallel HHS regulation covering the same SBC requirements for health insurance issuers.
- Fully-insured vs. self-funded: For fully-insured plans, the carrier typically prepares the SBC; the employer confirms distribution and maintains records. For self-funded plans, the employer or TPA must also prepare the SBC using the HHS template; the monitoring obligation is the same but the prep work is heavier.
- Carrier attestation policies vary: Some carriers require an annual employer attestation confirming how and when SBCs were delivered; others handle all SBC compliance themselves and ask nothing of the employer. Check your carrier's administrative guide or ask your broker before each renewal cycle.
- Multiple plan options: An SBC is required for each plan option offered. If you offer three tiers, each eligible participant receives all three SBCs before making an election, and you log all three.
- State requirements: A few states reinforce SBC requirements through state insurance regulations or market conduct audits. Carriers in those states tend to be stricter about requiring employer attestations; if your carrier is asking for more documentation than usual, this may be why.