When is the SBC due?
There is no single annual SBC deadline. The federal rule at 29 CFR 2590.715-2715 sets five triggers, each on its own clock, plus a separate notice rule for mid-year changes.
| Trigger | Deadline | Who receives it |
|---|---|---|
| Initial enrollment | With the written enrollment materials, or by the first date the employee is eligible to enroll if there are none | Every eligible employee, one SBC for each benefit package they can choose |
| Changes before coverage starts | No later than the first day of coverage | Anyone whose SBC information changed after they received it |
| Special enrollment | Within 90 days of enrollment, the same deadline as the SPD | Special enrollees, such as after a marriage, birth, adoption or loss of other coverage |
| Renewal, written application required | With the renewal application materials | Enrolled participants, for the option they are in |
| Renewal, automatic | 30 days before the first day of the new plan year | Enrolled participants, for the option they are in |
| On request | Within seven business days | Anyone eligible who asks, enrolled or not |
| Mid-year change that affects the SBC | At least 60 days before the change takes effect | All enrollees |
For a January 1 plan year with automatic renewal, the SBC is due December 2. If an insured policy has not been issued or renewed by then, the deadline becomes seven business days after the policy is issued or the carrier receives written confirmation of intent to renew, whichever is earlier. Treat that as a backstop, not a plan.
The same seven-business-day clock applies when the employer asks its carrier for an SBC, so a request made in the middle of open enrollment can push you past your own deadline. Ask early.
What is a summary of benefits and coverage?
The SBC is a standardized snapshot of what a health plan covers and what it costs the employee. It comes from the Affordable Care Act (Public Health Service Act section 2715), and its purpose is comparison: every SBC uses the same template, headings and coverage examples, so an employee can line up two plans side by side.
That is why the format rules are strict. Under 29 CFR 2590.715-2715, the SBC must:
- follow the uniform federal template and instructions;
- use terms the average enrollee can understand;
- run no longer than four double-sided pages;
- use no print smaller than 12-point font.
Employers often want to add a page about a wellness program, a carve-out vendor or telehealth. That material belongs in the enrollment guide or plan document, not the SBC.
Each SBC must also give an internet address for the uniform glossary of coverage and medical terms, a phone number for a paper copy, and a statement that paper copies are available. You must provide the glossary within seven business days of a request.
The DOL’s Summary of Benefits and Coverage page publishes the current template, a sample completed SBC, the glossary, and translations in Spanish, Chinese, Tagalog and Navajo. The current template applies to plan years beginning on or after January 1, 2021. If a vendor still produces SBCs on an older template, that is a finding waiting to happen.
Who has to provide it?
Both the group health plan, through its plan administrator, and the insurance carrier of an insured plan are responsible for providing the SBC. When either one delivers a timely, complete SBC to an employee, the requirement is met for both. That shared duty is why SBCs fall through the cracks: each party assumes the other has it handled.
Fully insured plans. The carrier prepares the SBC and has its own duty to provide it. Many employers still handle distribution through their enrollment materials. Agree in writing who sends each SBC, and keep proof that it went out.
Self-funded and level-funded plans. There is no carrier to share the duty. The plan administrator, usually the employer, owns the SBC from preparation to delivery, even when a third-party administrator drafts it. The regulation lets the plan contract the work out, but the plan meets its duty only if it:
- monitors the vendor’s performance under the contract;
- corrects any failure it learns about as soon as practicable, if it has the information to do so;
- otherwise tells affected employees about the failure and takes significant steps to prevent it from happening again.
Read your administrative services agreement and find out who prepares the SBC, who updates it when the plan changes, who distributes it, and who keeps the records. If the agreement says nothing, that is your first action item.
What is the 60-day notice of modification?
If you make a material change mid-year that would affect the content of the SBC, and the change is not already reflected in the most recent SBC, you must notify enrollees at least 60 days before it takes effect. Changes made at renewal are covered by the renewal SBC instead.
The notice can be an updated SBC or a separate notice that describes the change, delivered under the same rules as the SBC itself. The clock runs backward from the effective date, so the decision has to be final about two months before employees feel it.
That matters for any mid-year conversation about changing a network, adding a cost-sharing tier, moving pharmacy vendors or tightening prior authorization. A vendor promising a 30-day implementation is promising a compliance problem.
How can you deliver it?
You can always deliver the SBC on paper. Electronic delivery is allowed, with conditions that depend on who is receiving it.
- Employees already enrolled. Electronic delivery works under the DOL’s disclosure rules at 29 CFR 2520.104b-1, in connection with online enrollment or renewal, or in response to an online request. A paper copy must be provided whenever one is requested.
- Employees eligible but not enrolled. The electronic format must be readily accessible, a paper copy must be free on request, and if you post the SBC online you must notify each person by paper (such as a postcard) or email that it is posted, where to find it, and that paper copies are available.
That last step is the one most employers skip. Posting the SBC on the intranet is not delivery. The notice about the posting is.
One SBC per household. A single SBC sent to the participant’s last known address covers the participant and any beneficiaries there. A dependent known to live at a different address needs a separate copy.
Language access. In any county where 10 percent or more of residents are literate only in the same non-English language, the SBC must include a statement in that language on how to get help, and you must offer oral language services and a translated SBC on request (29 CFR 2590.715-2719(e)). Check the counties where employees live, not just where headquarters sits. The DOL page lists the counties.
Keep the proof. No regulation prescribes a recordkeeping format, which is exactly why you need one. Log the date, the population, the delivery method, the plan year and which benefit packages each SBC covered.
What does a missed SBC cost?
Two separate penalties can apply, and they stack.
| Penalty | Amount | How it works |
|---|---|---|
| DOL civil penalty, 29 CFR 2590.715-2715(e) | Up to $1,443 per failure | Applies to willful failures. Each participant or beneficiary who did not receive an SBC is a separate failure |
| IRS excise tax, Internal Revenue Code section 4980D | $100 a day for each affected person | Runs from the day the failure starts until it is corrected. Self-reported on Form 8928 |
The $1,443 figure is the DOL’s 2025 inflation-adjusted amount (90 FR 1854, January 10, 2025). The DOL made no adjustment for 2026 because the October 2025 inflation data was never published, and its May 27, 2026 notice (91 FR 31358) keeps the 2025 amounts in effect.
The SBC rules are part of the group health plan requirements the Internal Revenue Code enforces through section 9815, so a missed SBC falls under the section 4980D excise tax. The statute adds several limits and floors:
- Correction within 30 days. No tax applies if the failure was due to reasonable cause, not willful neglect, and is corrected within 30 days of when you knew or should have known about it.
- Cap for unintentional failures. For failures due to reasonable cause, the tax for the year is capped at the lesser of 10 percent of what the employer paid for group health plans in the prior year or $500,000.
- Minimums on audit. If the failure is still uncorrected when the IRS sends a notice of examination, the tax is at least $2,500 per affected person, or $15,000 if the violation is more than de minimis (but never more than the tax otherwise owed).
- Small employer exception. An employer with 2 to 50 employees whose plan is fully insured owes no excise tax for a failure caused solely by the carrier’s coverage.
The math adds up quickly. A renewal SBC that reaches 250 employees 45 days late is 250 × 45 × $100, or $1,125,000, before any cap.
The uncomfortable part is that the excise tax is self-reported. No agency sends a bill. Form 8928 is due on or before the due date of the employer’s federal income tax return, so an SBC failure nobody caught is also a return nobody filed.
How is an SBC different from an SPD?
The SBC is a short comparison tool required by the Affordable Care Act. The summary plan description (SPD) is ERISA’s full plain-language explanation of the plan: eligibility, claims and appeals, participant rights and how the plan can be amended or ended. Different laws, different content, different clocks. Handing out one does not satisfy the other.
The timing differences matter most when a plan changes:
- An ERISA summary of material modifications can go out up to 210 days after the end of the plan year in which the change was adopted.
- The SBC’s 60-day notice for a mid-year change has to go out before the change takes effect.
When both apply, the 60-day notice sets your project plan.
The request rules differ too. A written request for plan documents under ERISA must be answered within 30 days. A request for an SBC must be answered within seven business days. Employees rarely ask for a document by its legal name, so your process has to recognize either request.
What do employers get wrong?
The same mistakes show up at employers of every size:
- Assuming the carrier or TPA handled it. Shared responsibility is not transferred responsibility. Confirm in writing who does what, then check it was done.
- Sending one SBC when the plan offers three options. At enrollment, every benefit package an employee can choose needs its own SBC.
- Missing the 30-day renewal deadline. Employers with a January 1 plan year often distribute in mid-December, which is late.
- Forgetting new hires and special enrollees. The annual calendar covers renewal. It does not cover the person who enrolled in March.
- Treating a mid-year change as a 30-day project. The 60-day notice sets the floor.
- Posting without notice. For employees who are eligible but not enrolled, an intranet posting alone is not delivery.
- Using an outdated template. The current template applies to plan years beginning on or after January 1, 2021.
- Keeping no distribution records. Without proof, you cannot show the SBC went out.
How do you build an SBC calendar?
Employers that never have an SBC problem have turned the five triggers into five calendar entries, each with a named owner:
- Renewal. Request each SBC from your carrier or TPA well before renewal, which gives the vendor its seven business days and leaves time to review. Distribute at least 30 days before the plan year starts, and record the date.
- New hires. Put the SBC for every option in the new hire enrollment packet.
- Special enrollment. Add an SBC step to the special enrollment workflow, so a March birth triggers the same process as a December renewal.
- Requests. Name one person to answer SBC and glossary requests within seven business days.
- Mid-year changes. Put a 60-day checkpoint in front of any plan change discussion, before anything is signed.
The SBC is one item on the year-end health plan compliance checklist. Ethos Benefits builds the calendar, the ownership map and the records trail with clients as part of its compliance services, so each SBC goes out on time and you can prove it.