public-service · SBC disclosure requirements
SBC Disclosure Rules Under 45 CFR § 147.200: Format, Glossary, Timing
What federal rule 45 CFR § 147.200 requires for the Summary of Benefits and Coverage: format limits, glossary response time, and modification notice.
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What matters now
- SBC format is capped at four double-sided pages and no print smaller than 12-point font.
- SBC content must use plain language understandable by the average enrollee, in a uniform format.
- Plans must provide the Uniform Glossary within seven business days of a request.
- Material SBC changes require notice at least 60 days before they take effect.
Federal rule 45 CFR § 147.200 requires health plans and issuers to give enrollees a standardized disclosure document called the Summary of Benefits and Coverage (SBC), and it sets the format, glossary-response, and advance-notice rules that govern that document — not what any particular plan covers.
This original record-reading guide is a general reading aid, not cited evidence. It does not depict a source record; the article text and source links provide the facts.
Key points
- The SBC has a fixed format ceiling: it must not exceed four double-sided pages and must not use print smaller than 12-point font (45 CFR § 147.200).
- The SBC must use terminology the average enrollee can understand, and be presented in a uniform format across plans (45 CFR § 147.200).
- A plan or issuer must supply the required Uniform Glossary within seven business days of a request, in paper or electronic form as requested (45 CFR § 147.200).
- A material modification to SBC content requires notice no later than 60 days before the change takes effect (45 CFR § 147.200).
What the SBC format rule requires
The regulatory text states that “the SBC must be presented in a uniform format, use terminology understandable by the average plan enrollee (or, in the case of individual market coverage, the average individual covered under a health insurance policy), not exceed four double-sided pages in length, and not include print smaller than 12-point font” (45 CFR § 147.200). This is a format and readability standard: it fixes length, print size, and plain-language expectations for the document, regardless of which plan issues it.
Getting the Uniform Glossary
The rule also creates a companion document, the Uniform Glossary, and a fixed response deadline for it: “A plan or issuer must make the uniform glossary described in this paragraph (c) available upon request, in either paper or electronic form (as requested), within seven business days after receipt of the request” (45 CFR § 147.200). A reader who asks a plan or issuer for the glossary has a seven-business-day response window written directly into federal rule.
Notice before a material change
When a plan or issuer changes something that would need to appear on the SBC, the rule requires advance notice: the modification must be disclosed “not later than 60 days prior to the date on which the modification will become effective” (45 CFR § 147.200). This 60-day window applies to material modifications to SBC content occurring outside the plan’s regular renewal or reissuance cycle.
Rule history
The current text of this section carries the following Federal Register citation: “[80 FR 34310, June 16, 2015, as amended at 81 FR 61581, Sept. 6, 2016]” (45 CFR § 147.200).
What this article does not answer
This article describes only the disclosure-format requirements in 45 CFR 147.200. It does not describe the benefits of a particular plan or apply the requirements to a particular disclosure.