Summary of Benefits and Coverage

Under the Affordable Care Act (ACA), all issuers of health insurance are required to provide consumers with clear, consistent and comparable information about their health plan benefits and coverage — a Summary of Benefits and Coverage (SBC).

In California, all issuers of dental insurance are required to provide consumers with a Summary of Dental Benefits and Coverage disclosure matrix (SDBC). See the "How Can I get an SBC/SDBC?" section below to view an SDBC. 

The SBC is like a nutritional label for a health insurance plan. The eight-page form displays information about a health plan in a simple question-and-answer format. It answers questions like:

• What is the overall deductible?
• Is there an out-of-pocket limit on my expenses?
• Does this plan use a network of providers?
• Are there services this plan does not cover?

To get familiar with everything that’s included and where to look for it, here is a sample SBC^F56 for your reference.

If you need clarification on what certain terms mean, check out commonly used health insurance terms in our glossary.