The Affordable Care Act (ACA) in the US means the country’s insurers are now required to provide consumers in the private health insurance market with a brief summary of what a health insurance policy or employer plan covers.

Consumers will also be provided with a uniform glossary, containing standard, consumer-friendly insurance and medical terms.

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The Summary of Benefits and Coverage (SBC) will include information about the covered health benefits, out-of-pocket costs, and the network of providers. It will also include a comparison tool, called Coverage Examples.

Coverage Example is modelled on the nutrition facts label required for packaged food, that helps consumers compare coverage options by showing a standardized sample of what each health plan will cover for two common medical situations—having a baby and managing type 2 diabetes. 

The SBC became available from 24 September for consumers in the individual health insurance market. 

This information can be requested at any time, but it will also be made available when shopping for, enrolling in or renewing coverage.  It will also be provided whenever information in the SBC changes significantly. 

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Kathleen Sebelius, health and human services (HHS) secretary, said: “These new tools empower consumers to make informed decisions about their health coverage options and choose the plan that is best for them, their families, and their business.”

Both the SBC and glossary were developed in collaboration with a range of stakeholders including the Department of Labour, Department of Treasury and the insurance industry.