What Is an SBC?
The Summary of Benefits and Coverage (SBC) is a standardized, consumer-friendly document that every health insurance plan must provide under the ACA. It uses a consistent format so you can compare plans side-by-side — same layout, same terms, same coverage examples.
What the SBC Includes
- Monthly premium
- Deductible amounts (individual and family)
- Out-of-pocket maximum
- Copay and coinsurance for common services
- Covered services with cost details
- Excluded services
- Two coverage examples: Having a baby (normal delivery) and managing Type 2 diabetes — showing estimated total costs for each scenario
The coverage examples are the most useful part. They show real-world scenarios with estimated total costs — including deductible, copays, and coinsurance. This makes it much easier to compare plans than looking at individual cost-sharing numbers in isolation.
Where to Find the SBC
- ACA marketplace (Healthcare.gov) — click "Plan Details" on any plan
- Insurance carrier websites — usually under plan documents
- Your employer — must provide during enrollment
- Request one — insurers must provide it free within 7 business days
SBCs are required for all ACA-compliant plans — both marketplace and private. Non-ACA plans (short-term, indemnity) are not required to provide an SBC, which makes comparing them to ACA plans harder.
Related Terms
Last updated: March 30, 2026.
